Atrial Fibrillation (AFib or AF)

Overview

Atrial fibrillation is a tachycardia arrhythmia. It occurs when the upper chambers of the heart (atria) begin to quiver or begin to beat irregularly and can't pump blood into the lower chambers (ventricles) effectively. The American Heart Association estimates that approximately 2.7 million Americans are living with AFib.

The most common symptom of AFib is the quivering or fluttering heartbeat. Often, patients feel tired, weak, confusion, or a sense of dizziness and should seek medical help.

There are multiple types of AFib, including:

• Paroxysmal AFib: Experiencing an irregular heartbeat but returns to normal on its own.
• Persistent AFib: AFib doesn't stop on its own and cannot be restored to normal without medications.
• Long-Standing AFib: Formally known as Permanent AFib, AFib cannot be restored to normal with medications and electrical shocks.
• Nonvalvular AFib: heart valve issues do not cause A Fib.

Atrial fibrillation causes

Possible causes of AFib include:

• Hypertension
• A previous heart attack
• Coronary artery disease
• Abnormal heart valves
• Congenital heart defects
• Exposure to stimulants like medications, alcohol, tobacco or caffeine
• Overactive thyroid

Atrial fibrillation risk factors

There are several risk factors for AFib, including:

• Age (being over the age of 60)
• Hypertension
• Coronary artery disease
• Diabetes
• Congestive heart failure
• Structural heart disease
• Cardiomyopathy
• Pericardial inflammation

Atrial fibrillation symptoms

The most common symptom is an uncomfortable and racing irregular heartbeat. Some patients might not experience symptoms and not know they have it until they get a checkup with their doctor.

Other symptoms include:

• Irregular heartbeat
• Fatigue
• Chest pain
• Dizziness and lightheadedness
• Feeling confused
• Shortness of breath
• Fainting

Atrial fibrillation prevention

You can lower your chances of developing AFib through the following:

• Adopting a healthy diet such as the Mediterranean-style diet
• Taking the necessary steps to prevent:
  • Coronary artery disease
  • High blood pressure

Atrial fibrillation diagnosis

After a doctor looks at your medical history and symptoms, they can better determine what diagnostic test to perform.

• Electrocardiogram (ECG or EKG): Records the electrical signals that pass through the heart.
• Holter monitor: Portable ECG used to record heart activity over a short duration of time.
• Event Recorder: Portable ECG used to monitor heart activity over weeks or months. You will press a button when you experience an episode so that the episode can be recorded and evaluated by your doctor.
• Echocardiogram: Uses sound waves to see your heart's activity visually.
• Mobile Cardiac Monitor: Records the heart’s rhythm for up to 30 days.
• CT (computed tomography) or MRI (magnetic resonance imaging): Used to take detailed images of the heart and lungs.
• Transesophageal echocardiogram (TEE): During a transesophageal echocardiogram, a special medical camera will take a picture of the back of the heart from inside the esophagus.
• Transthoracic echocardiogram (TTE): Takes a picture to see how the heart is functioning and to see its size.

Atrial fibrillation treatment

After your doctor evaluates your symptoms, he or she can better determine which treatment would be most appropriate. The goal of the treatment is to bring the heart rhythm back to normal and prevent any clotting from forming.

Your doctor can prescribe you medications, but other forms of treatment include:

• Medications
• Electrical cardioversion: Shocking the heart in hopes of resetting the heart to a normal rhythm.
• Radiofrequency ablation: A radiofrequency ablation is a procedure that involves the ablating (burning) tiny parts of the heart that are causing your irregular heartbeats.
• Surgical treatment: During surgical treatment for A Fib, your doctor may implant a pacemaker under the skin to maintain heart rhythm.
• Open-heart maze procedure: An open-heart maze procedure is an invasive procedure where your doctor will cut and stitch parts of the heart to form scar tissue. The scar tissue will interfere with A Fib impulses. An open-heart maze procedure is only performed when all other treatments have failed.
• Pulsed field ablation: a pulsed field ablation treatment utilizing pulsed electrical fields rather than thermal ablation, and effectively, efficiently, and safely treats both paroxysmal and persistent atrial fibrillation.

When should I seek care?

If you are experiencing AFib along with chest pain, shortness of breath, weakness, or fainting, call 911 right away. If your AFib comes and goes at irregular intervals, call for treatment as soon as possible within 24 hours.

Next Steps

Your doctor will be able to recommend the best treatment for your case. Changes to your lifestyle and medications may be recommended to help prevent some of the risk factors associated with atrial fibrillation. Maintaining a healthy lifestyle may include eating a heart-healthy diet, avoiding the urge to smoke, watching your weight, and reducing stress. 

Contact your doctor if your symptoms change or worsen.