What Do You Want to Know About Atrial Fibrillation?

Medically reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI on October 9, 2017Written by Rose Kivi and Marijane Leonard

What is atrial fibrillaton?

At least 2.7 million people in the United States have atrial fibrillation. It’s the most common type of heart arrhythmia (irregular heartbeat) that can interrupt the normal flow of blood.

This interruption means the condition puts you at risk of blood clots and stroke. Atrial fibrillation may be temporary, may come and go, or may be permanent. However, with appropriate medical care, you can live a normal, active life.

What causes atrial fibrillation?

The heart contains four chambers: two atria and two ventricles. Atrial fibrillation occurs when these chambers don’t work together as they should because of faulty electrical signaling. Normally, the atria and ventricles contract at the same speed. In atrial fibrillation, the atria and ventricles are out of sync because the atria contract very quickly and irregularly.

Atrial fibrillation is often referred to as sick sinus syndrome because the sinoatrial (sinus) node in the right atrium controls the electrical impulses.

The cause of atrial fibrillation isn’t always known. Conditions that can cause damage to the heart and lead to atrial fibrillation include:

  • high blood pressure
  • congestive heart failure
  • coronary artery disease
  • heart valve disease
  • hypertrophic cardiomyopathy, in which the heart muscle becomes thick
  • heart surgery
  • congenital heart defects, meaning heart defects you’re born with
  • an overactive thyroid gland
  • pericarditis, which is inflammation of the sac-like covering of the heart
  • taking certain medications
  • binge drinking
  • thyroid disease

Who is at risk for atrial fibrillation?

The following factors increase your risk of atrial fibrillation:

  • increased age (the older you are, the higher your risk)
  • being white
  • being male
  • heart disease
  • structural heart defects
  • congenital heart defects
  • pericarditis
  • history of heart attacks
  • history of heart surgery
  • thyroid conditions
  • metabolic syndrome
  • obesity
  • lung disease
  • diabetes
  • drinking alcohol, especially binge drinking

The following might increase your risk:

  • a family history of atrial fibrillation
  • sleep apnea
  • high-dose steroid therapy

What are the symptoms of atrial fibrillation?

You might not experience any symptoms if you have atrial fibrillation. However, you might experience one or more of the following:

  • heart palpitations (feeling like your heart is skipping a beat, beating too fast or hard, or fluttering)
  • chest pain
  • fatigue
  • shortness of breath
  • weakness
  • lightheadedness
  • dizziness
  • fainting
  • confusion

How is atrial fibrillation diagnosed?

Your doctor may use one or more of the following tests to diagnose atrial fibrillation:

  • A physical exam to check your pulse, blood pressure, and lungs.
  • Electrocardiogram (EKG), a test that records the electric impulses of your heart for a few seconds. If atrial fibrillation doesn’t occur during this test, your doctor may have you wear a portable EKG monitor. These include:
    • Holter monitor, a small portable device you wear for 24 to 48 hours to monitor your heart.
    • Event monitor, a device that records your heart only at certain times or when you are having symptoms. It’s worn for weeks or until atrial fibrillation symptoms occur.
    • Echocardiogram, a noninvasive test that uses sound waves to produce a moving image of your heart.
    • Transesophageal echocardiogram, an invasive version of an echocardiogram that is performed by placing a probe in the esophagus.
    • Stress test, which monitors your heart during exercise.
    • A chest X-ray to view your heart and lungs.
    • Blood tests to check for thyroid and metabolic conditions.

How is atrial fibrillation treated?

You might not need treatment if you don’t have symptoms, if you don’t have other heart problems, or if the atrial fibrillation stops on its own. If you do require treatment, your doctor may recommend one or more of the following:

Medication

  • medications to normalize the speed of your heart contractions
  • medications to prevent atrial fibrillation
  • blood-thinning medications to prevent blood clots from forming

Procedures

  • Electrical cardioversion. A brief electrical shock resets the rhythm of your heart contractions.
  • Catheter ablation. A catheter delivers radio waves to the heart to destroy the abnormal tissue that sends out irregular impulses.
  • Atrioventricular (AV) node ablation. Radio waves destroy the AV node, which connects the atria and ventricles. Then the atria can no longer send signals to the ventricles. A pacemaker is inserted to maintain a regular rhythm.
  • Maze surgery. This is an invasive surgery that can be either open-heart or through small incisions in the chest, during which the surgeon makes small cuts or burns in the heart’s atria to create a “maze” of scars that will prevent abnormal electrical impulses from reaching other areas of the heart. This surgery is only used in cases when other treatments were unsuccessful.

Surgery

Your doctor might also recommend treatment for underlying health conditions, such as a thyroid problem or heart disease, that might be causing atrial fibrillation.

Outlook

Most cases of atrial fibrillation can be managed or treated. However, atrial fibrillation tends to reoccur and get worse over time.

The most common complications of atrial fibrillation are strokes and heart failure. If you have atrial fibrillation and aren’t taking proper medication, you are five times more likely to have a stroke than people who don’t have atrial fibrillation, according to the Centers for Disease Control and Prevention.

Prevention

You can reduce your risk of atrial fibrillation by doing the following:

  • Eat a diet that is rich in fresh fruits and vegetables and low in saturated and trans fat.
  • Exercise regularly.
  • Maintain a healthy weight.
  • Avoid smoking.
  • Avoid drinking alcohol or only drink small amounts of alcohol occasionally.
  • Follow your doctor’s advice for treating any underlying health conditions that you have.
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