Atrial fibrillation (patient information)
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What is Atrial fibrillation?
Atrial fibrillation/flutter is a heart rhythm disorder (arrhythmia). It usually involves a rapid heart rate, in which the upper heart chambers (atria) are stimulated to contract in a very disorganized and abnormal manner.
What are the symptoms of Atrial fibrillation?
You may not be aware that your heart is not beating in a normal pattern, especially if it has been occurring for some time.
Symptoms may include:
- Pulse that feels rapid, racing, pounding, fluttering, or too slow
- Pulse that feels regular or irregular
- Sensation of feeling the heart beat (palpitations)
- Shortness of breath while lying down
- Confusion
- Dizziness, light-headedness
- Fainting
- Fatigue
Note: Symptoms may begin or stop suddenly.
What causes Atrial fibrillation?
Arrhythmias are caused by a disruption of the normal electrical conduction system of the heart.
Normally, the four chambers of the heart (two atria and two ventricles) contract in a very specific, coordinated way. The electrial impulse that signals your heart to contract in a synchronized way begins in the sinoatrial node (SA node). This node is your heart's natural pacemaker.
The signal leaves the SA node and travels through the two upper chambers (atria). Then the signal passes through another node (the AV node), and finally, through the lower chambers (ventricles). This path enables the chambers to contract in a coordinated fashion.
In atrial fibrillation, the atria are stimulated to contract very quickly and differently from the normal pattern. The impulses are sent to the ventricles in an irregular pattern. This makes the ventricles beat abnormally, leading to an irregular (and usually fast) pulse.
In atrial flutter, the ventricles may beat very fast, but in a regular pattern.
If the atrial fibrillation/flutter is part of a condition called sick sinus syndrome, the sinus node may not work properly. The heart rate may alternate between slow and fast. As a result, there may not be enough blood to meet the needs of the body.
Atrial fibrillation can affect both men and women. It becomes more common with increasing age.
Causes of atrial fibrillation include:
- Alcohol use (especially binge drinking)
- Congestive heart failure
- Coronary artery disease (especially after a heart attack or coronary artery bypass surgery)
- Heart surgery
- High blood pressure (hypertension)
- Hypertrophic cardiomyopathy
- Medications
- Overactive thyroid gland (hyperthyroidism)
- Pericarditis
- Valvular heart disease (especially mitral stenosis and mitral regurgitation)
When to seek urgent medical care
Call your health care provider if you have symptoms of atrial fibrillation or flutter
Treatment options
The health care provider may may perform the following tests for this condition: An ECG shows atrial fibrillation or atrial flutter. Continuous ambulatory cardiac monitoring -- Holter monitor (24 hour test) -- may be necessary because the condition often occurs at some times but not others (sporadic).
Tests to find underlying heart diseases may include:
- Coronary angiography
- Echocardiogram
- Electrophysiologic study (EPS)
- Exercise treadmill ECG or Stress test
- Nuclear imaging tests
Where to find medical care for Atrial fibrillation
Directions to Hospitals Treating Atrial fibrillation