Atrial fibrillation (AFib) is an irregular heart rhythm caused by chaotic electrical signals in the upper chambers (atria) of the heart. This condition causes the heart to beat faster and more irregularly than normal, increasing the risk of blood clots. It is a common arrhythmia that poses a stroke risk and is especially common in people over 65 years of age.
- What is atrial fibrillation?
- What are the symptoms of atrial fibrillation?
- What causes atrial fibrillation?
- How is atrial fibrillation diagnosed?
- How is atrial fibrillation treated?
- What should people with atrial fibrillation pay attention to?
- What are the risks of atrial fibrillation?
- When should you consult a doctor?
- Frequently asked questions
- Dictionary
What is atrial fibrillation?
Atrial fibrillation is an arrhythmia that occurs when the upper chambers of the heart, called atria, contract irregularly and usually rapidly. This condition causes the heartbeat to become uncontrolled and increases the risk of clots. It is also called AF or AFib.
In atrial fibrillation, 300-600 numerous random electrical stimuli occur per minute in the atria. Some of these stimuli pass to the ventricles, causing the heart to beat rapidly and irregularly 100-175 times per minute. The heart cannot contract effectively enough, blood flow slows, and the risk of clot formation and stroke increases.
Atrial fibrillation is sometimes temporary and resolves on its own. Sometimes it continues persistently and requires treatment. Normal life can be maintained with early diagnosis and appropriate treatment.
What are the types of atrial fibrillation?
Atrial fibrillation is divided into different types based on its duration and frequency. This classification plays an important role in determining the treatment approach.
Paroxysmal atrial fibrillation is characterized by episodes that usually last from a few minutes to a week. Attacks end spontaneously and may not require any medical intervention. However, this does not mean the condition is mild; paroxysmal atrial fibrillation can become more permanent over time.
Persistent atrial fibrillation is atrial fibrillation that lasts longer than seven days and usually requires medical intervention such as drug treatment or electrical cardioversion (applying electric shock to the heart rhythm). This type does not return to normal rhythm spontaneously.
Long-term persistent atrial fibrillation describes continuous atrial fibrillation lasting longer than one year. At this stage, rhythm control strategies can be more challenging.
Permanent atrial fibrillation refers to the situation where the person and doctor do not aim to return to normal sinus rhythm and rhythm control strategies are no longer considered. In this situation, the goal is to prevent complications with approaches such as rate control and anticoagulant therapy (blood thinners).
What are the symptoms of atrial fibrillation?
Atrial fibrillation symptoms vary from person to person. Some patients experience no symptoms and AFib is detected during routine check-ups. Symptoms can start suddenly or develop gradually.
The most common symptom is palpitations. The heart feels like it’s beating irregularly, rapidly, or strongly. Shortness of breath becomes especially apparent with exertion. Chest pain or pressure may be experienced. Fatigue and weakness are common in atrial fibrillation. Dizziness, fainting, and feelings of restlessness may also accompany. Some patients only notice that their heartbeat has changed.
Atrial fibrillation symptoms:
- Palpitations
- Irregular heartbeat
- Shortness of breath
- Chest pain or pressure
- Fatigue and weakness
- Dizziness
- Fainting
- Feeling of restlessness
What causes atrial fibrillation?
Atrial fibrillation has many causes. Aging is the most important risk factor. Changes in the heart muscle with age facilitate arrhythmias.
High blood pressure is the most common cause of atrial fibrillation. Diabetes, being overweight, and sleep apnea also increase the risk. Heart diseases increase the risk of atrial fibrillation. Coronary artery disease, heart valve diseases, and heart failure are important causes. Thyroid diseases, especially hyperthyroidism, can also trigger it.
Alcohol use, stress, and excessive caffeine consumption can trigger atrial fibrillation attacks. Some medications and illicit drugs also cause arrhythmias.
Atrial fibrillation risk factors:
- Aging
- High blood pressure
- Diabetes
- Obesity
- Sleep apnea
- Coronary artery disease
- Heart valve diseases
- Heart failure
- Thyroid diseases
- Excessive alcohol use
How is atrial fibrillation diagnosed?
Usually an electrocardiography (ECG) is sufficient to detect atrial fibrillation. However, since this arrhythmia occurs intermittently in some people, longer-term monitoring methods such as continuously recorded heart rhythm (Holter monitor) or event recorders may be preferred. This way, arrhythmia attacks can be caught more easily.
In some cases, additional tests such as blood tests (such as thyroid function tests), chest X-ray, or stress test may also be requested. All these tests help understand the cause of atrial fibrillation and create the most appropriate treatment plan.
How is atrial fibrillation treated?
The main goals of atrial fibrillation treatment are to control your heart rate, regulate your heart rhythm, and most importantly, reduce stroke risk. Treatment options include blood thinning medications, medications that provide rhythm and rate control, electrical cardioversion, and interventional methods such as ablation. The treatment plan is determined individually according to the type of AFib, symptoms, and general health condition.
Atrial fibrillation treatment options:
- Drug therapy (antiarrhythmic and blood thinning)
- Electrical cardioversion
- Catheter ablation
- Pacemaker
- LAA closure
- Lifestyle changes
Drug therapy
Antiarrhythmic drugs regulate heart rhythm and reduce atrial fibrillation attacks. Medications such as amiodarone, flecainide, and propafenone are used. These drugs help maintain normal heart rhythm.
Rate control medications normalize heart rate. Beta blockers (metoprolol, atenolol), calcium channel blockers (diltiazem, verapamil), and digoxin are used. These drugs do not correct the rhythm but slow the heart rate.
Blood thinning medications are the most critical part of atrial fibrillation treatment. Medications such as warfarin, apixaban, rivaroxaban, dabigatran prevent clot formation. This treatment greatly reduces stroke risk.
Cardioversion therapy
Electrical cardioversion restores normal rhythm by giving a controlled electric shock to the heart. The procedure is performed under anesthesia and the patient feels no pain. The shock restarts the heart and provides regular rhythm.
Cardioversion is usually successful but atrial fibrillation may recur. Blood thinning treatment is required before the procedure. If there are no clots in the heart, cardioversion can be safely applied.
Ablation therapy
AFib Ablation corrects abnormal electrical foci in the heart that cause atrial fibrillation with various energies (heat, cold, or electric field). Thin cables are sent to the heart from the groin vessel. With these energies, tissues causing problems (usually around pulmonary veins) are isolated and normal heart rhythm is achieved.
Pacemaker therapy
Pacemaker is used in patients with slow heart rhythm. Some atrial fibrillation patients experience very slow heartbeat. Pacemaker ensures the heart works fast enough. Pacemaker is a small device placed under the chest. Its wires are connected to the heart muscle and it gives electrical stimulation when needed. Modern batteries are long-lasting and MRI compatible.
LAA closure therapy
LAA closure is applied to patients who cannot use blood thinning medications. The left atrial appendix is the area where clot formation most commonly occurs in the heart. Closing this area with a special device reduces stroke risk. The procedure is performed via catheter. The LAA opening is closed with a special plug. This way, stroke protection is provided without using blood thinners.
Lifestyle changes
Regular exercise reduces atrial fibrillation symptoms. 150 minutes of moderate-intensity exercise per week is recommended. Swimming, walking, and cycling are ideal choices. Healthy nutrition and weight control are important. Mediterranean diet, low-salt nutrition, and plenty of vegetable-fruit consumption are beneficial. Obesity increases atrial fibrillation risk. Limit or completely stop alcohol use. Alcohol triggers atrial fibrillation attacks. Don’t smoke and learn stress management. Adequate sleep and regular life control atrial fibrillation.
What should people with atrial fibrillation pay attention to?
Regular medication use is the foundation of atrial fibrillation management. Never stop blood thinning medications. Don’t miss your doctor check-ups. Pay attention to drug interactions. Consult your doctor before starting new medications. Inform all doctors, including dentists, about your atrial fibrillation treatment.
What are the risks of atrial fibrillation?
The most serious complication of atrial fibrillation is stroke. Blood flow slows in the atria and clots can form. If these clots go to brain vessels, they cause stroke. Stroke risk is 5 times higher than in the normal population.
Heart failure can be seen in atrial fibrillation. Irregular and rapid heartbeat tires the heart muscle. Over time, the heart may become unable to pump enough blood.
Other arrhythmias can also develop. Rhythm problems such as atrial flutter or more serious ventricular tachycardia may occur.
When should you consult a doctor?
- Go to the emergency room in case of severe chest pain, inability to breathe, or fainting. If your heart rate speeds up a lot (over 150 per minute) and you feel very bad, don’t wait.
- If you have serious bleeding while using blood thinners, apply to the hospital immediately. If you have an accident or fall, you should be evaluated for internal bleeding.
- If you see stroke symptoms, emergency intervention is required. Sudden speech disorder, facial paralysis, arm-leg weakness are signs of stroke. Call emergency services without wasting time.
Frequently asked questions
Does atrial fibrillation progress?
AFib can progress over time. Attacks that are initially intermittent (paroxysmal) can become more frequent and longer-lasting (persistent) over time. If untreated, it carries the risk of turning into a continuous (permanent) form.
Is it possible to live with atrial fibrillation?
Yes, a quality life with atrial fibrillation is possible. Regular doctor control, medication compliance, and healthy lifestyle habits are critical for this.
Does atrial fibrillation prevent sports?
Light or moderate exercise is safe and even beneficial for most patients. Still, exercise planning should be done under doctor supervision.
Does atrial fibrillation shorten lifespan?
The effect of atrial fibrillation on lifespan depends on many factors. In a well-managed condition, lifespan can be similar to healthy individuals. However, in untreated or uncontrolled cases, quality and duration of life can be negatively affected.
What is the pulse rate in atrial fibrillation?
In atrial fibrillation, the atria vibrate 300-600 times per minute, but not all of these stimuli reach the ventricles. Still, the pulse usually rises to between 100-175. Normally, the resting pulse for adults is between 60-100 per minute.
Dictionary
What is atrium?
Atrium is the name given to each of the upper chambers of the heart. The heart has two atria, right and left. Atria have thinner walls compared to ventricles and their main function is to receive incoming blood and transfer it to the ventricles below. These chambers also host the regions where the heart’s electrical stimulation begins. For example, the sinus node, which is the heart’s natural pacemaker, is located in the right atrium. The regular functioning of the atria is important for the heart’s general rhythm and efficient blood circulation.
What is ventricle?
Ventricle is the name given to each of the two lower chambers of the heart. The heart has two ventricles, right and left. Ventricles are the parts of the heart with strong muscle layers and undertake the main pumping function. Especially the left ventricle has a thicker wall structure because it sends blood to the entire body. Healthy functioning of the ventricles ensures that adequate amounts of oxygenated blood reach the body’s organs.
What is fibrillation?
Fibrillation means the incompatible, very fast and irregular contraction of muscle fibers in the heart. In this situation, the heart’s normal rhythmic contractions are disrupted and effective blood pumping becomes difficult.
The two most common types of fibrillation:
Atrial fibrillation is seen in the atria of the heart. Since the atria work irregularly and very rapidly, blood flow to the ventricles can be disrupted and the heart’s blood pumping efficiency can decrease. It can lead to clot formation, increasing stroke risk.
Ventricular fibrillation develops in the ventricles of the heart and is the most dangerous life-threatening arrhythmia. The heart does not pump blood to the body and results in death if not intervened.
In summary, fibrillation is the chaotic stimulation of muscle cells in certain parts of the heart and usually refers to a serious arrhythmia that requires treatment.
What is atrial?
Atrial means belonging to or related to the atria, which are the upper chambers of the heart. The heart contains two atria, the right atrium and left atrium. These chambers are the blood collection part of the heart and work together with the ventricles below to pump blood to the body and lungs.
Reference: Atrial Fibrillation
