What is atrial fibrillation?

What Is Atrial Fibrillation?

Atrial fibrillation

Atrial fibrillation (say "AY-tree-uhl fih-bruh-LAY-shun") is a type of irregular heartbeat (arrhythmia) in which the heart's upper chambers quiver, or fibrillate. This increases the risk of blood clots, which can cause a stroke or other problems. The lower chambers beat without a regular rhythm and may beat too fast. This can cause symptoms like a fluttering, racing, or pounding feeling in your chest called palpitations. Other symptoms include being short of breath or tired.

Treatment is done to control your heart rate or heart rhythm and to prevent stroke.

What can you expect when you have atrial fibrillation?

At first, episodes of atrial fibrillation may come on suddenly and last a short time. They may go away on their own or with treatment. Over time, the episodes may last longer and occur more often. If this continues, they may not go away on their own.

What are the symptoms of atrial fibrillation?

Some people feel symptoms when they have episodes of atrial fibrillation. But other people don't notice any symptoms.

If you have symptoms, you may feel:

  • A fluttering, racing, or pounding feeling in your chest called palpitations.
  • Weak or tired.
  • Dizzy or lightheaded.
  • Short of breath.
  • Chest pain.

You may notice signs of atrial fibrillation when you check your pulse. Your pulse may seem uneven or fast.

How is atrial fibrillation treated?

Treatments for atrial fibrillation can help you feel better and prevent future problems. The main types of treatment slow the heart rate, control the heart rhythm, and help prevent stroke. You will likely take medicine. You may have a procedure, such as electrical cardioversion or catheter ablation.

Catheter ablation for atrial fibrillation

How the heart's electrical system works

Electrical system of the heart.

In a normal heart, the sinoatrial (SA) node triggers the electrical impulse, causing the upper chambers (atria) to contract. The signal travels through the atrioventricular (AV) node to the atrioventricular bundle, which divides into the Purkinje fibers that carry the signal and cause the lower chambers (ventricles) to contract. The electrocardiogram (EKG, ECG) tracing shows this normal electrical activity.

How atrial fibrillation happens

Right and left atria of heart with details showing fibrillation in an atrium, and EKG patterns of fibrillation and normal rhythm.

In atrial fibrillation, erratic electrical impulses can cause the upper chambers of the heart (atria) to fibrillate, or quiver, resulting in an irregular and frequently rapid heart rate. The irregular, sawtooth pattern in the electrocardiogram (EKG, ECG) tracing shows these erratic impulses.

Catheter is threaded through a vein to the heart

How a catheter is inserted through a vein to the heart.

For this nonsurgical procedure called catheter ablation, thin tubes called catheters are inserted into a vein, typically in the groin or neck, and threaded through the vein into the heart. A small puncture in the tissue that divides the right and left chambers (septum) allows the catheter to pass into the left atrium.

Heart tissue is destroyed

Heart tissue is destroyed (ablation).

An electrode at the tip of a catheter sends out energy, such as radio waves, that destroys (ablates) the tissue that is causing atrial fibrillation. In this image, the energy is destroying tissue at the base of the pulmonary vein. (The pulmonary veins bring blood back from the lungs to the heart.)

Scar tissue prevents or eliminates impulses

How scar tissue from ablation stops electrical impulses.

Catheter ablation creates scar tissue that prevents impulses from leaving the pulmonary veins or eliminates the impulses altogether.

How is atrial fibrillation diagnosed?

To see if you have atrial fibrillation, you will have an electrocardiogram (EKG or ECG). An EKG is a test that checks for problems with the heart's electrical activity. Your doctor will do a physical exam. You may have other tests that check the health of your heart.

How can you decide about taking medicine to lower your stroke risk when you have atrial fibrillation?

When you know what your stroke risk is, you and your doctor can talk about your options. You'll decide whether or not to take medicine, called an anticoagulant, to help prevent blood clots.

These medicines are often called blood thinners, but they don't actually thin your blood. Instead, they increase the time it takes for a blood clot to form.

Blood thinners lower the risk of stroke in people who have atrial fibrillation. But how much your risk will be lowered depends on how high your risk was to start with.

There are risks to taking a blood thinner. When your blood clots more slowly, you have a higher risk of bleeding problems. These problems include bleeding problems in and around the brain, bleeding in the stomach and intestines, bruising and bleeding if you are hurt, and serious skin rash.

You and your doctor can compare your risk of stroke with your risk of bleeding from the medicine. You can also discuss how you feel about taking medicine every day.

How can you care for yourself when you have atrial fibrillation?

Many people are able to live full and active lives with atrial fibrillation. You can live well and help manage your condition by having a heart-healthy lifestyle, taking medicine properly, and managing other health problems. You can work with your doctor to help manage your symptoms.

Atrial Fibrillation: Feeling More in Control

Atrial Fibrillation: Managing Your Symptoms

What increases your risk for atrial fibrillation?

A risk factor is anything that increases your chances of getting sick or having a problem. Risk factors for atrial fibrillation include:

  • Age older than 60.
  • Being white and male.
  • Obesity.
  • Sleep apnea.
  • A family history of atrial fibrillation.
  • Other health problems that can cause atrial fibrillation. These include high blood pressure and certain heart problems.

Other things that can increase the risk for atrial fibrillation include:

  • Long-term, heavy alcohol use, or drinking a large amount of alcohol at one time (binge drinking).
  • Smoking.
  • Not being active.

How can you decide about electrical cardioversion for atrial fibrillation?

What are the options for treating atrial fibrillation?

Atrial fibrillation (say "AY-tree-uhl fih-bruh-LAY-shun") is a kind of uneven heartbeat. It can make you feel dizzy, tired, or short of breath. It also can make you more likely to have a stroke.

To treat it, you may:

  • Have electrical cardioversion.
  • Try other treatments to restore a normal heart rhythm and relieve your symptoms. You might try catheter ablation. Or you may take medicines to control your heart rate or rhythm.

Use this information to help you and your doctor decide if cardioversion may be a good option for you.

How does cardioversion treat atrial fibrillation?

Electrical cardioversion is one treatment option to try to stop atrial fibrillation and keep it from coming back. It can also relieve symptoms of atrial fibrillation.

First, you'll get medicines through a vein. They will block pain and make you sleepy (I.V. sedation). Then your doctor will put patches on your chest or your chest and back. The patches send a brief electric shock to your heart. This resets your heart rhythm.

Your doctor may have you take rhythm‐control medicines before and after cardioversion. These are called antiarrhythmics. They can make it more likely that your heart rhythm will get back to normal and stay there. You will probably take a blood-thinner medicine (anticoagulant). This is to prevent blood clots before and after the procedure. This medicine lowers your risk of a stroke.

For most people, this treatment restores a normal heart rhythm right away. But atrial fibrillation often comes back. If it does, talk with your doctor about your next treatment options. You may be able to have cardioversion again. Or your doctor might have you try a different treatment, such as catheter ablation. Or you might take medicines to control your heart rate or rhythm.

What are key points about this decision?

  • Cardioversion can return your heart to a normal rhythm. This helps relieve symptoms of atrial fibrillation.
  • For most people, cardioversion restores a normal heart rhythm right away. But atrial fibrillation often comes back. Many things can affect how long the heart stays in a normal rhythm. Your doctor can help you understand how well this treatment might work for you.
  • Cardioversion is just one way to treat atrial fibrillation. If atrial fibrillation returns after this procedure, you may try cardioversion again. Or you can choose another treatment.
  • Cardioversion does have some risks. These range from minor burns from the patches to a stroke. Your doctor can help you weigh your risks against the possible benefits.
  • No matter what treatment you choose, you will need to take steps to prevent a stroke, manage other health problems, and have a heart-healthy lifestyle.

Your decision

What you decide will depend on how you feel about the benefits and risks of your options. Talk to your doctor about what matters most to you. Together, you can make the decision that's right for you.

What is atrial fibrillation?

Atrial fibrillation (say "AY-tree-uhl fih-bruh-LAY-shun") is a type of irregular heartbeat (arrhythmia). The heart's upper chambers (atria) quiver, or fibrillate. The lower heart chambers may also beat fast and without a regular rhythm.

What causes atrial fibrillation?

Atrial fibrillation is caused by health problems that damage or strain the heart and its electrical system. These problems include high blood pressure, coronary artery disease, and heart failure. Other causes include heart surgery, lung disease, or an overactive thyroid gland.

What is a heart-healthy lifestyle for atrial fibrillation?

A heart-healthy lifestyle includes being active, staying at a weight that is healthy for you, and eating heart-healthy foods. Avoid alcohol if it triggers symptoms. Try to quit or cut back on smoking. Try to get enough sleep, manage stress, and manage other health conditions.

Atrial fibrillation: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.
    After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.
  • You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

  • You have new or increased shortness of breath.
  • You feel dizzy or lightheaded, or you feel like you may faint.
  • You have an episode of atrial fibrillation and your doctor wants you to call when you have one.
  • You have new or worse symptoms.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.