Atrial Fibrillation

Atrial fibrillation is an irregular heart rhythm that starts in the upper parts (atria) of the heart.

Normally, the heart beats in a strong, steady rhythm. In atrial fibrillation, a problem with the heart’s electrical system causes the atria to quiver, or fibrillate. The quivering upsets the normal rhythm between the atria and the lower parts (ventricles) of the heart. The lower parts may beat fast and without a regular rhythm.

Atrial fibrillation is dangerous because it greatly increases the risk of stroke. If the heart doesn’t beat strongly, blood can collect, or pool, in the atria. Pooled blood is more likely to form clots. If the heart pumps a clot into the bloodstream, the clot can travel to the brain and block blood flow, causing a stroke. Atrial fibrillation can also lead to heart failure.

Conditions that damage or strain the heart commonly cause atrial fibrillation. These include: high blood pressure, coronary artery disease, heart attack, heart valve disease. Atrial fibrillation may also be caused by: other medical problems, such as lung disease, pneumonia, or a high thyroid level (hyperthyroidism), heart surgery, heavy alcohol use, use of caffeine, nicotine, decongestants, and cocaine.

Sometimes doctors can’t find the cause. Doctors call this lone atrial fibrillation.

Symptoms may include feeling dizzy, out of breath, feeling weak and tired, a feeling that the heart is beating unevenly, chest pain, fainting.

The best way to find out if you have atrial fibrillation is to have an  electrocardiogram (ECG or EKG). An EKG is a test that checks for problems with the heart’s electrical activity.

You might also have lab tests, a chest X-ray, and an echocardiogram. An echocardiogram can show how well your heart is pumping and whether your heart valves are damaged.

A number of treatments may be used for atrial fibrillation. Which treatments are best for you depend on the cause, your symptoms, and your risk of stroke.

Doctors sometimes use a procedure called cardioversion to try to get the heartbeat back to a normal rhythm. This can be done using either medicine or a low-voltage electrical shock (electrical cardioversion).  Atrial fibrillation often comes back after cardioversion.

If you have mild symptoms, or if atrial fibrillation returns after cardioversion, your doctor may prescribe medicines to control your heart rate and help prevent stroke.

Many people with atrial fibrillation need to take blood-thinning (anticoagulant) medicine to help prevent strokes. People at low risk for stroke may take daily aspirin instead.

Cardioversion and medicines don’t work for some people who continue to have bothersome symptoms. In these cases, doctors sometimes recommend a procedure called ablation. Ablation destroys small areas of the heart. This creates scar tissue, which blocks or destroys areas that cause or maintain the irregular heart rhythm. Afterward, you may need a pacemaker to keep your heart beating regularly.

Atrial fibrillation is often the result of heart disease or damage. So making changes that improve the condition of your heart may also improve your overall health: don’t smoke, eat a heart-healthy diet, get regular exercise, control your cholesterol and blood pressure, keep your blood sugar in your target range, manage your stress level, avoid caffeine, alcohol, and stimulants.