Atrial fibrillation (AF or A-fib) is a common heart rhythm disorder (arrhythmia), in which the heart beats irregularly and too fast. The condition is not life-threatening, but must be treated in order to prevent heart damage. Some people feel nothing, but in others the symptoms, such as palpitations, may be very nasty and limiting.
Cause
The heart has a sinus node, which controls the rhythm of the heart. This sinus node delivers electrical impulses, causing the heart to contract and blood to be pushed into the right direction. In case of atrial fibrillation, the sinus node delivers too many impulses. Thus, the atria have to contract faster than normal, with the consequence that the chambers cannot keep up with the rhythm. As a result, blood does not flow properly through the heart.
Atrial fibrillation can be caused by other diseases:
- High blood pressure.
- Diabetes.
- Cardiac disorders.
- Thyroid disease.
- Inflammation.
- COPD.
Conditions or treatments that can trigger an attack of atrial fibrillation include: fever, anemia, stress and heart surgery. Certain nutrients and substances, such as alcohol, coffee, drugs and some medicines, can also trigger an attack.
Finally, a person is more likely to develop atrial fibrillation in case of overweight or sleep apnea (cessation of breathing during sleep).
Symptoms
Although atrial fibrillation does not necessarily have to cause physical symptoms, the following signs and symptoms may occur:
- Palpitations.
- Shortness of breath.
- Dizziness, light in the head.
- Pressure, pain or discomfort in the chest.
- Confusion.
- Quickly tired during exercise.
When a person suffers from atrial fibrillation, there is a chance that a clot is developed in the heart. This clot can end up in the arteries and cause a stroke. Atrial fibrillation can occur in attacks (if it lasts no longer than seven days), but can also persist longer or even be permanent.
Diagnosis
On suspicion that the symptoms may be related to atrial fibrillation, the doctor will do a physical examination. Blood pressure is measured, the pulse is recorded and the heart is listened to. The actual diagnosis is made with the aid of an electrocardiogram (ECG). If the ECG might prove nothing, it can be decided to monitor the heart rhythm for 24 hours with the aid of a device that the patient wears on the body, the so-called Holter recording.
Treatment
In case of a short attack of less than 48 hours, the probability of spontaneous recovery is high. If no recovery occurs and improving lifestyle doesn’t help, the doctor can treat atrial fibrillation with medication or surgery.
If a doctor prescribes medication, he or she can choose between medication aimed at controlling the rhythm disorder and medication that dilate the blood and thus prevent clots and strokes.
An example of a surgical procedure to restore heart rhythm is cardioversion. In this procedure, the patient is anesthetized, after which the doctor gives the heart an electric shock. Afterwards, the heart can pick up a healthy rhythm again. If the atrial fibrillation comes back, the doctor may still prescribe medication to prevent further problems.
Prognosis
The prognosis for atrial fibrillation is generally good. The condition is not life-threatening, but must always be treated. Even if a person has few symptoms, treatment helps to prevent any complications.