Atrial Fibrillation

In AF, blood pools in the atria. It isn’t pumped completely into the heart’s two lower chambers, called the ventricles. As a result, the heart’s upper and lower chambers don’t work together as they should.

People who have AF may not feel symptoms. However, even when AF isn’t noticed, it can increase the risk of stroke. In some people, AF can cause chest pain or heart failure, especially if the heart rhythm is very rapid.

AF may happen rarely or every now and then, or it may become an ongoing or long-term heart problem that lasts for years.

Prevention

Following a healthy lifestyle and taking steps to lower your risk for heart disease may help you prevent atrial fibrillation. These steps include:

• Following a heart healthy diet that’s low in saturated fat, trans fat, and cholesterol. A healthy diet includes a variety of whole grains, fruits, and vegetables daily.
• Not smoking.
• Being physically active.
• Maintaining a healthy weight.

If you already have heart disease or other AF risk factors, work with your doctor to manage your condition. In addition to adopting the healthy habits above, which can help control heart disease, your doctor may advise you to:

• Keep your cholesterol and triglycerides at healthy levels with dietary changes and medicines (if prescribed).
• Limit or avoid alcohol.
• Control your blood sugar level if you have diabetes.
• Get ongoing medical care and take your medicines as prescribed.

Risk Factors

Atrial fibrillation (AF) affects millions of people, and the number is rising. Men are more likely than women to have the condition. In the United States, AF is more common among Whites than African Americans or Hispanic Americans.

The risk of AF increases as you age. This is mostly because your risk for heart disease and other conditions that can cause AF also increases as you age. However, about half of the people who have AF are younger than 75.

AF is more common in people who have:

• High blood pressure
• Coronary heart disease
• Heart failure
• Rheumatic heart disease
• Structural heart defects
• Pericarditis
• Congenital heart defects
• Sick sinus syndrome

AF also is more common in people who are having heart attacks or who have just had surgery.

Other conditions that raise your risk for AF include hyperthyroidism (too much thyroid hormone), obesity, diabetes, and lung disease.

Certain factors also can raise your risk for AF. For example, drinking large amounts of alcohol, especially binge drinking, raises your risk. Even modest amounts of alcohol can trigger AF in some people. Caffeine or psychological stress also may trigger AF in some people.

Metabolic syndrome also raises your risk for AF. Metabolic syndrome is the name for a group of risk factors that raises your risk for CHD and other health problems, such as diabetes and stroke.

Research suggests that people who receive high-dose steroid therapy are also at increased risk for AF.

Causes

Atrial fibrillation (AF) occurs if the heart’s electrical signals don’t travel through the heart in a normal way. Instead, they become very rapid and disorganized.

Damage to the heart’s electrical system causes AF. The damage most often is the result of other conditions that affect the health of the heart, such as high blood pressure and coronary heart disease.

The risk of AF increases as you age. Inflammation also is thought to play a role in causing AF.

Symptoms

AF can lead to signs and symptoms, such as:

• Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or fast)
• Shortness of breath
• Weakness or problems exercising
• Chest pain
• Dizziness or fainting
• Fatigue (tiredness)
• Confusion

Diagnosis

Atrial fibrillation (AF) is diagnosed based on your medical and family histories, a physical exam, and the results from tests and procedures.

Sometimes AF doesn’t cause signs or symptoms. Thus, it may be found during a physical exam or EKG(electrocardiogram) test done for another purpose.

Treatment

Treatment for atrial fibrillation (AF) depends on how often you have symptoms, how severe they are, and whether you already have heart disease. General treatment options include medicines, medical procedures, and lifestyle changes.

People who have AF but don’t have symptoms or related heart problems may not need treatment. AF may even go back to a normal heart rhythm on its own.

In some people who have AF for the first time, doctors may choose to use an electrical procedure or medicine to restore a normal heart rhythm. Repeat episodes of AF tend to cause changes to the heart’s electrical system, leading to persistent or permanent AF. Most people who have persistent or permanent AF need treatment to control their heart rate and prevent complications.

Your doctor may recommend treatments for an underlying cause of AF or to reduce AF risk factors. For example, he or she may prescribe medicines to treat an overactive thyroid, lower high blood pressure or manage high blood cholesterol.

Your doctor also may recommend lifestyle changes, such as following a healthy diet, cutting back on salt intake (to help lower blood pressure), quitting smoking, and reducing stress.

Limiting or avoiding alcohol, caffeine, or other stimulants that may increase your heart rate also can help reduce your risk for AF.

Recovery

People who have atrial fibrillation (AF)—even permanent AF—can live normal, active lives. If you have AF, ongoing medical care is important.

Follow your doctor’s instructions for taking medicines. Be careful about taking over-the-counter medicines, nutritional supplements, and cold and allergy medicines. Some of these products contain stimulants that can trigger rapid heart rhythms. Also, some over-the-counter medicines can have harmful interactions with heart rhythm medicines.

If you’re taking blood-thinning medicines, you’ll need to be carefully monitored. For example, you may need routine blood tests to check how the medicines are working. Also, talk with your doctor about your diet. Some foods, such as leafy green vegetables, may interfere with warfarin, a blood-thinning medicine.

Ask your doctor about physical activity, weight control, and alcohol use. Find out what steps you can take to manage your condition.