Atrial fibrillation (AF), also known as A-fib, is the most common type of irregular heartbeat (arrhythmia) of the heart’s upper chambers (atria) which can lead to strokes, heart failure, blood clots in the heart and/or blockage of blood flow (ischemia) in the heart or other organs.
Atrial fibrillation is frequently combined with a rapid heart rate (tachycardia) and occurs when the upper chambers of the heart (atria) receive abnormal electrical signals from the heart’s conduction system that causes the atria to quiver.
Atrial fibrillation is categorized by the following four main types:
Occasional (Paroxysmal) atrial fibrillation – This type of atrial fibrillation comes and goes, can last from minutes to hours, or even last as long as a week, or occur repeatedly, and may go away on its own.
Persistent atrial fibrillation – In this type of atrial fibrillation, the irregular heart rhythm (arrythmia) doesn’t go away on its own and needs treatment to restore normal rhythm.
Long-standing persistent atrial fibrillation – This type of atrial fibrillation occurs continuously, lasting longer than 12 months. Permanent atrial fibrillation – In this type of atrial fibrillation, the irregular heart rhythm cannot be restored to normal, in which case it becomes permanent, requiring heart medications and anticoagulants to prevent blood clots.
Atrial fibrillation that occurs in individuals who do not have any heart defects or damage is called lone atrial fibrillation.
Atrial fibrillation is often abbreviated to AF or A-fib.
Atrial fibrillation can be caused by high blood pressure (hypertension), overactive thyroid (hyperthyroidism), viral infections, coronary artery disease, abnormal heart valves, congenital heart defects, sick sinus syndrome (abnormal heart electrical impulses), sleep apnea, lung diseases, such as pneumonia or sarcoidosis, rheumatic heart disease, previous heart surgery, stress due to surgery, venous thromboembolism (blood clots), heart failure, and heart attack (cardiac arrest).
Additional risk factors for developing atrial fibrillation include aging, chronic conditions such as thyroid disorders, metabolic syndrome, diabetes, chronic kidney or lung disease, drinking alcohol, especially binge drinking, obesity, illegal drug use such as cocaine, being a competitive athlete, smoking, experiencing high levels of stress, and having a family history of atrial fibrillation.
While atrial fibrillation can occur without notice of any symptoms, usual symptoms of atrial fibrillation include weakness, shortness of breath, reduced ability to exercise, low blood pressure (hypotension), lightheadedness, dizziness, fainting, heart palpitations (uncomfortable, racing, irregular heartbeat), and chest pain.
Symptoms of atrial fibrillation may only occur occasionally or frequently and may worsen and become permanent.
Treatment for atrial fibrillation focuses on restoring normal heart rhythm, if possible, and avoiding the incidence of blood clots, strokes, and other complications and includes a combination of lifestyle changes, medications, and surgical procedures and techniques to help restore normal heart rhythm.
In addition, any underlying disorders that contribute to the risk of atrial fibrillation, such as overweight or obesity, overactive thyroid (hyperthyroidism), or sleep apnea will also require treatment.
Lifestyle changes – Lifestyle changes for atrial fibrillation include heart-healthy diet, such as the DASH diet, with lower sodium intake, exercise, quitting street drugs, limiting or avoiding alcohol, managing stress, quitting smoking, and weight loss.
Medications – Medications for atrial fibrillation include beta blockers, such as metoprolol, carvedilol, and atenolol, which help to slow heart rate; blood thinners (direct-acting anticoagulants ), such as edoxaban, dabigatran, or warfarin, heparin, and clopidogrel, to help prevent blood clots and stroke; calcium channel blockers, such as diltiazem and verapamil, which help control heart rate; digitalis or digoxin, which control the rate that blood is pumped throughout the body; and other heart rhythm medications.
Anti-arrhythmic drugs, such as dofetilide, flecainide, propafenone, amiadarone, and solatol, may be administered after catheter ablation to prevent the recurrence of atrial fibrillation.
Catheter or surgical ablation – This procedure destroys the tissue that is causing the atrial fibrillation and may need to be repeated if the atrial fibrillation recurs and can be used in combination with pacemaker implantation.
Electrical cardioversion – This procedure for treating atrial fibrillation restores normal heart rhythm through the use of low-energy shocks to the heart and may be used in an emergency.
Pacemaker implantation – A pacemaker may be implanted for atrial fibrillation if another arrythmia (irregular heartbeat) is present.
Left atrial appendage ligation – This surgical procedure for atrial fibrillation can be used to prevent blood clots and stroke and may be performed at the same time as catheter ablation.
The outcomes (prognosis) for atrial fibrillation depend on its cause; if the cause is treatable, the atrial fibrillation may go away after treatment.
More commonly, atrial fibrillation is a life-long condition, especially when other long-term cardiac conditions are present.
Possible complications of atrial fibrillation include blood clots, stroke, cognitive impairment and vascular dementia, heart attack (sudden cardiac arrest), and heart failure.
The risk of stroke and other complications can be reduced through the use of anticoagulant (blood thinning) medications.
If you experience any of the symptoms of atrial fibrillation, such as palpitations, weakness, dizziness, shortness of breath, or fainting, make an appointment with your doctor as soon as possible.
If you experience chest pain, seek immediate emergency assistance.
While some causes of atrial fibrillation cannot be prevented, it is possible to reduce the risk of developing atrial fibrillation by living a heart-healthy lifestyle, including eating a heart-healthy diet that avoids foods rich in saturated or trans fats and refined carbohydrates, performing regular, moderate physical activity, quitting or avoiding smoking, quitting or avoiding illegal drugs, such as cocaine, limiting or avoiding caffeine and alcohol, managing stress, avoiding medications that can increase heart rate, controlling blood sugar, lowering blood pressure and cholesterol, and maintaining a healthy weight.