Atrial Fibrillation

What is atrial fibrillation?

Atrial fibrillation is an abnormal heart rhythm which occurs when the top chambers of the heart beat rapidly and irregularly.  These top chambers typically beat at 300-400 beats per minute during atrial fibrillation.  This irregular rhythm may last for seconds, hours, or days.  It can also become a permanent condition.  

What are the signs and symptoms of atrial fibrillation?

Patients may experience a variety of symptoms which can include a sensation of a rapid heart rate, palpitations, fatigue, lightheadedness, fainting, shortness of breath, or chest pain.  Many patients with atrial fibrillation have no symptoms at all.

What causes atrial fibrillation?

Atrial fibrillation can be caused by a number of conditions such as hypertension, blood clots in the lungs, inflammation around the heart, blockages in the arteries of the heart, thyroid abnormalities, and infection.  It can also be triggered by the consumption of caffeine, alcohol, and chocolate.  Many patients have no identifiable conditions or causes and this is referred to as idiopathic atrial fibrillation. 

What are the risks of atrial fibrillation?

One of the major risks of atrial fibrillation is the development of blood clot in the heart which can lead to strokes.  The risk of developing a blood clot with atrial fibrillation is related to the duration of atrial fibrillation and the presence of other risk factors for stroke such as hypertension, diabetes, congestive heart failure, age, and abnormal heart valves.  This risk of stroke can be reduced with a blood thinner called warfarin.  The other risk of atrial fibrillation is weakening of the heart if it causes the bottom of the heart to beat rapidly for months or years. 

How is atrial fibrillation treated?

There are many treatment options available for the treatment of atrial fibrillation.  The best treatment option for any one individual patient depends upon the frequency of episodes of their atrial fibrillation, the heart rate during atrial fibrillation, the severity of their symptoms while in atrial fibrillation, and their other medical conditions.  There is no single treatment option that is best for every patient.  For some patients, the best treatment option is to allow them to remain in atrial fibrillation.  The goal for these patients is to ensure that their heart is not beating too rapidly and that they are on blood thinner to blood clot. 
For other patients, it is important that regular rhythm is restored and maintained.  These patients may require a cardioversion, the use of antiarrhythmic medications, or a special procedure called an atrial fibrillation ablation.  Many of these patients for whom regular rhythm is restored are still require to remain on a blood thinner.