Atrial fibrillation

Atrial fibrillation, commonly called AFib, is an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots, stroke, heart failure, and other heart-related complications. In AFib, the heart's upper chambers (the atria) beat chaotically and out of sync with the lower chambers (the ventricles). 

Signs and symptoms

While some people with AFib may not have any symptoms, others can experience a range of issues. The symptoms depend on how fast the heart is beating and how effectively it is pumping blood. 

Common symptoms include:

  • Heart palpitations: A fluttering, throbbing, or rapid beating in the chest.

  • Shortness of breath: Difficulty catching your breath, especially with exercise or when lying down.

  • Fatigue or weakness: Feeling more tired or run down than usual.

  • Dizziness or lightheadedness: Feelings of being unsteady or fainting.

  • Chest pain or pressure: Any chest pain should be evaluated immediately to rule out a heart attack.

  • Confusion or fainting: This can occur with a very rapid heart rate. 

Diagnosis

AFib is diagnosed with a physical exam and heart rhythm monitoring. If you have any symptoms, especially if they are new or worsening, it is important to see a doctor.

  • Electrocardiogram (EKG/ECG): This is the most common and important test for diagnosing AFib. It measures the heart's electrical activity and can detect an irregular rhythm.

  • Heart rhythm monitors: If your AFib comes and goes (paroxysmal), you may need a wearable monitor to track your heart's rhythm over a longer period.

    • Holter monitor: A portable device worn for 24 to 48 hours.

    • Implantable loop recorder: A small chip inserted under the skin for long-term monitoring.

  • Echocardiogram: An ultrasound of the heart that helps evaluate its structure and function.

  • Blood tests: May be performed to check for underlying conditions that could contribute to AFib, such as thyroid disease. 

Treatment

The goals of treating AFib are to control symptoms, slow the heart rate, and prevent complications like stroke. 

Managing heart rate and rhythm

  • Medications: A doctor may prescribe medicine to control your heart's rate and rhythm.

    • Beta-blockers: Help slow your heart rate.

    • Calcium channel blockers: Help control the heart rate.

  • Electrical cardioversion: A procedure where an electric shock is delivered to the heart to reset it to a normal rhythm. This is done while you are sedated.

  • Catheter ablation: A minimally invasive procedure where a catheter is used to create tiny scars in the heart tissue, which blocks the abnormal electrical signals causing AFib. 

Preventing stroke

  • Blood thinners: These are crucial for people with AFib to prevent blood clots from forming in the heart, which could lead to a stroke. Your doctor will determine if you need blood thinners based on your individual risk factors.

  • Left atrial appendage closure: For those who cannot take blood thinners, a procedure can be performed to close off a small pouch in the heart where most clots form. 

Lifestyle changes

  • Maintain a healthy weight: Being overweight is a risk factor for AFib.

  • Eat a heart-healthy diet: Follow a diet low in salt and rich in fruits and vegetables.

  • Exercise regularly: Regular physical activity can help control blood pressure and improve overall heart health.

  • Limit alcohol and caffeine: These can trigger AFib episodes in some people.

  • Manage underlying conditions: Control other health issues like high blood pressure, diabetes, or sleep apnea, which can contribute to AFib

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