Atrial fibrillation
Atrial fibrillation is the most common long‑lasting heart rhythm disorder. In this condition, the atria of the heart do not contract normally but instead fibrillate rapidly and irregularly. This can weaken the heart’s pumping ability and predispose to the formation of blood clots, which may cause a stroke.
Atrial fibrillation may be occasional, recurrent, or permanent. It occurs especially in older individuals, but also in younger people – particularly if there are underlying heart diseases, high blood pressure, or structural changes in the heart.
Causes of atrial fibrillation
Several factors predispose to atrial fibrillation. The most common underlying causes include:
- High blood pressure
- Coronary artery disease
- Heart failure
- Heart valve disorders
- Cardiomyopathies
- Hyperthyroidism
- Sleep apnea
- Heavy alcohol use
- Age – the risk increases significantly after 65 years
Symptoms of atrial fibrillation
The symptoms of atrial fibrillation vary widely. Some people experience clear and bothersome symptoms, while for others the arrhythmia may be almost or completely asymptomatic.
Typical symptoms include:
- Palpitations or an irregular heartbeat
- Shortness of breath, especially during exertion
- Fatigue and reduced exercise capacity
- Dizziness or fainting
- A distressing sensation in the chest
- General weakness
Sometimes atrial fibrillation is detected incidentally, for example during a blood pressure measurement or an ECG.
Why is atrial fibrillation dangerous?
As a result of atrial fibrillation, blood flow in the atria slows down, which can lead to the formation of a blood clot, particularly in the left atrial appendage. If the clot travels to the brain, it can cause a stroke.
Atrial fibrillation increases the risk of stroke up to fivefold. It can also weaken the heart’s pumping ability and lead to heart failure.
Diagnosis of atrial fibrillation
Atrial fibrillation is diagnosed with an electrocardiogram (ECG). If the arrhythmia is not continuous, the following may be used:
24‑hour ECG monitoring (Holter)
Rhythm monitoring devices or smartphone ECG
Echocardiography to assess the structure and function of the heart
Blood tests to rule out other conditions (e.g., thyroid function tests)
Treatment of atrial fibrillation
The treatment of atrial fibrillation is tailored individually based on symptoms, underlying conditions, and heart function. The goals of treatment are to:
- Prevent stroke
- Control the rhythm and relieve symptoms
- Improve quality of life
1. Anticoagulation
To prevent stroke, anticoagulant therapy (e.g., apixaban, rivaroxaban, warfarin) is often initiated, especially if the patient has other risk factors (age, high blood pressure, diabetes, etc.).
2. Treatment of the arrhythmia
Rhythm control can be achieved by:
- Medications that slow the heart rate or aim to restore normal rhythm
- Electrical cardioversion
- Catheter ablation, in which the abnormal rhythm is prevented by ablating the problematic area in the heart
In some patients, long‑term rate control is chosen, allowing the rhythm to remain in atrial fibrillation while keeping the heart rate normal.
Living with atrial fibrillation
Many people can live a good and full life despite atrial fibrillation. Important factors include:
- Regular medical follow‑up
- Consistent use of prescribed medications
- Exercise and healthy lifestyle habits
- Avoiding alcohol and smoking
- Weight management and treatment of sleep apnea
When to see a doctor?
Contact a doctor if:
You experience palpitations, dizziness, or an irregular heartbeat
You have already been diagnosed with atrial fibrillation and need an assessment of medication or procedures
You suspect asymptomatic atrial fibrillation (e.g., there is a family history of arrhythmias or strokes)
Atrial fibrillation is a common and often manageable arrhythmia. At the Heart Center, we provide precise diagnostics and individualized treatment for the best care of your heart – with the goal of a healthy rhythm and a safe everyday life.