Atrial fibrillation

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Atrial fibrillation is the most common cardiac arythmia, which results in a rapid heart rhythm. Atrial fibrillation is caused by a disturbance in the heart’s electrical impulse, which causes the heart’s atrial chambers to contract more rapidly than would otherwise be the case.

The heart is an electrical wiresystem. Normally electrical impulses emanate from a small area in the right atrium and spread to the rest of the heart. In the case of atrial fibrillation, the chambers contract rapidly and in an uncoordinated way. This results in a fast and irregular heart rhythm and less blood is pumped out into the body.

Atrial fibrillation is not dangerous if treated.

The most serious complication of atrial fibrillation is blood clots in the brain. During an attack of atrial fibrillation, the blood moves slowly through the atrial chambers, which can cause small blood clots. If these blood clots are pumped out of the heart, they could travel to the brain and lead to a stroke. Based on your risk factors the doctor will assess your need for blood thinning treatment.

Untreated atrial fibrillation causes the heart to pump less efficiently, which can lead to heart failure.

Symptoms

Some patients do not notice the increased heart rhythm. Others develop symptoms, which can either occur occasionally or be continuous.

Common symptoms are:

Abnormal fatigue
Palpitations
Fast irregular pulse rate
Shortness of breath
Chest pain
Dizziness

Cause of disease

Atrial fibrillation can affect all but frequency increases with age.

Risk factors for developing atrial fibrillation are:

Age
High blood pressure
Increased metabolism
Predisposition in the family
Infections
Diabetes
Various heart conditions
Chronic lung disease
Obesity
Alcoholism
Stress
Surgery

About the treatment

A rapid, irregular pulse can lead to suspicions of atrial fibrillation. The condition is diagnosed by recording an electrocardiogram (ECG), which will show an irregular heart rhythm.

Atrial fibrillation is perceived as a chronic disease that can change from shorter to longer attacks through the years. The treatment will thus also need to be adjusted regularly.

The treatment of atrial fibrillation is individual but the goal is always to:

reduce symptoms
prevent blood clots
reduce the risk of heart failure

One of these treatment strategies is selected, based on your symptoms:

Frequency regulating medicine that slows the pulse rate to relieve the heart and reduce symptoms.
Stabilising medicine to maintain sinus rhythm.

Other forms of treatment of atrial fibrillation, often combined with medicine are:

DC conversion (an electric shock under full anaesthetic).
Radio frequency ablation (thermotherapy of the heart muscle cells causing the atrial fibrillation).
Surgery (Maze operation).

Furthermore, it is very important to minimize risk factors as they can contribute to maintain atrial fibrillation.