Atrial Fibrillation: Causes, Symptoms & Treatment

Overview

Atrial fibrillation, also known as AFib or AF, is an irregular heartbeat (arrhythmia) that can increase the risk of blood clots, stroke, heart failure, and other heart-related complications. When this condition happens, your upper and lower chambers of the heart can’t work together as usual. As a result, the lower chambers are not able to fill completely or pump enough blood to your lungs and body, which may lead to some symptoms, such as heart palpitations, shortness of breath and weakness. Moreover, your risk of developing stroke, and other-heart related complications will be increased.

Depending on the frequency of atrial fibrillation and its response to treatment, AF can be divided into four main types, including paroxysmal, persistent, long-term persistent, and permanent atrial fibrillation.

Atrial fibrillation is one of the most common arrhythmias. Based on statistics, people suffering from atrial fibrillation in the USA is about 2.7 million to 6.1 million, which may rise to 12.1 million in 2030.

Causes

Changes to the heart’s electrical signal and damage to its structure are the most common causes of atrial fibrillation. You will have a higher risk of developing this condition if you have:

  • High blood pressure
  • Coronary heart disease, heart defects, or heart failure
  • Rheumatic heart disease or pericarditis
  • Hyperthyroidism
  • Obesity
  • Diabetes or metabolic syndrome
  • Lung disease or kidney disease
  • Sleep apnea
  • A family history of AFib

It is also possible that some patients don’t have any heart defects or damage. This can be referred to as lone atrial fibrillation. Serious complications are rare though the exact cause of lone atrial fibrillation is unclear.

Atrial flutter

Atrial flutter is a condition similar to atrial fibrillation, but with more organized and less chaotic rhythm. In some cases, it may develop into atrial fibrillation and vice versa.

Risk factors

Some factors may put you at a high risk of atrial fibrillation. They include:

  • Age. The risk increases as you grow old, especially after age 65.
  • Heart disease. Anyone with heart disease — such as heart valve problems, congenital heart disease, congestive heart failure, coronary artery disease, or a history of heart attack or heart surgery — has an increased risk of atrial fibrillation.
  • High blood pressure. Having high blood pressure, especially if it’s not well-controlled with lifestyle changes or medications, can increase your risk of atrial fibrillation.
  • Other chronic conditions. People with certain chronic conditions such as thyroid problems, sleep apnea, metabolic syndrome, diabetes, chronic kidney disease or lung disease have a greater risk of atrial fibrillation.
  • Lifestyle habits. Some lifestyle habits may raise the risk as well, including drinking large amounts of alcohol, using illegal drugs, participating in endurance sports, smoking, experiencing stressful situations.
  • Obesity. People who are obese are at higher risk of developing atrial fibrillation.
  • Family history. An increased risk of atrial fibrillation is present in some families.
  • Surgery. Surgery of the heart, lungs, or esophagus will raise your risk of atrial fibrillation in the early days and weeks. People who have a surgery to correct a congenital heart defect will also have a higher risk of atrial fibrillation. This can happen years after a childhood surgery or when you have surgery as an adult to correct a lifelong condition.

Symptoms

Some people who have atrial fibrillation may have no symptoms at all. If you do have symptoms, you may experience:

  • Palpitations, which are sensations of a racing, uncomfortable, irregular heartbeat or a flip-flopping in your chest
  • Weakness
  • Reduced ability to exercise
  • Fatigue
  • Lightheadedness
  • Dizziness
  • Confusion
  • Shortness of breath
  • Chest pain

Diagnosis

After reviewing your signs and medical history, and conducting a physical examination, your doctor may perform the following tests to diagnose atrial fibrillation:

  • Electrocardiogram (ECG). A primary tool for diagnosing atrial fibrillation.
  • Holter monitor. Records your heart’s activity for 24 hours or longer, which provides your doctor with a prolonged look at your heart rhythms.
  • Event recorder. monitors your heart activity over a few weeks to a few months. You activate it only when you experience symptoms of a fast heart rate. This permits your doctor to determine your heart rhythm at the time of your symptoms.
  • Provides video images of your heart in motion, to detect underlying structural heart disease. Doctors may also conduct transesophageal echocardiography. It can produce images of your heart, which may be seen more clearly with this type of echocardiogram. Doctors may use this test to detect blood clots that may have formed in your heart.
  • Blood tests. Help your doctor rule out thyroid problems or other substances in your blood that may lead to atrial fibrillation.
  • Stress test. Also called exercise testing, involves running tests on your heart while you’re exercising.
  • Chest X-ray. Helps your doctor see the condition of your lungs and heart and diagnose conditions other than atrial fibrillation that may explain your signs and symptoms.

Treatment

Atrial fibrillation is usually treated by lifestyle changes, medicines, procedures, and surgery.

Firstly, you doctor may recommend some lifestyle changes that will be beneficial to your condition, such as:

  • Heart-healthy eating patterns such as the DASH eating plan, which reduces salt intake to help lower blood pressure
  • Being physically active
  • Getting help if you are trying to stop using street drugs
  • Limiting or avoiding alcohol or other stimulants that may increase your heart rate
  • Managing stress
  • Quitting smoking.

Secondly, you may be prescribed some types of medicine to help slow your heart rate or to make your heart’s rhythm more normal. They include:

  • Beta blockers, such as metoprolol, carvedilol, and atenolol.

Beta Blockers: Uses & Side Effects

  • Blood thinners. used to prevent blood clots and lower the risk of stroke, including warfarin, dabigatran, heparin, and clopidogrel.

Warfarin – Coumadin, Jantoven

Dabigatran: Uses & Side Effects

Heparin – Use & side effects

Clopidogrel – Plavix

  • Calcium channel blocker, such as diltiazem and verapamil.

Diltiazem – Uses & Side effects

Verapamil – Uses & Side effects

  • Digitalis, or digoxin. You should be cautious when using this type of medicine, for it can lead to other arrhythmias.

Digoxin: Uses & Side Effects

  • Other heart rhythm medicines.

Some medicines used to treat the underlying cause may also be recommended by your doctor, such as medicines to treat an overactive thyroid, lower high blood pressure, or manage high blood cholesterol.

Last but not least, if you are not able to get better with lifestyle changes and medicines, your doctor will take surgery into consideration. Options may include:

  • Catheter ablation. To destroy the tissue that is causing the arrhythmia.
  • Electrical cardioversion. To restore your heart rhythm using low-energy shocks to your heart.
  • To reduce atrial fibrillation when it is triggered by a slow heartbeat.
  • Plugging, closing, or cutting off the left atrial appendage. To prevent clots from forming in the area and causing a stroke.
  • Surgical ablation. To destroy heart tissue generating faulty electrical signals.

Keyword: atrial fibrillation

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.