Atrial Fibrillation


What is Atrial Fibrillation (AF)?

Atrial fibrillation is an irregular and often rapid heart rate that commonly causes poor blood flow to the body. During atrial fibrillation, the two upper chambers of the heart (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart. This chaotic activity causes turbid flow of blood in these chambers, raising the possibility that blood can pool and generate clots. If these clots propagate forward, they can cause a stroke.


What are the symptoms of AF?

Many patients experience palpitations, fatigue, chest pain, shortness of breath, weakness, and lightheadedness. These can occur because atrial fibrillation causes the ventricles to beat fast and irregularly. Other patients experience symptoms from the irregularity of atrial fibrillation itself even when the ventricles are beating slowly. Some people with atrial fibrillation have no symptoms and are unaware of their condition.


What causes AF?

Many patients with AF have areas of their heart that initiate abnormal electrical activity. Those areas may be amenable to ablation. Other common causes include prior cardiac conditions such as heart attacks or congestive heart failure. Many patients with AF have abnormal heart valves particularly diseases of the mitral valve. Other conditions that predispose to AF include high blood pressure, sick sinus syndrome, previous heart surgery, viral infections, or sleep apnea.


What is the treatment for AF?

Patients can be put back into normal rhythm through a procedure called a cardioversion. The procedure is fast. Anesthesia is given so that there is minimal to no pain. After a cardioversion, strategies to maintain normal rhythm include medications (antiarrhythmics) or a procedure called an ablation. An ablation tends to be a more successful strategy than medications. Blood thinners (anticoagulants) can reduce the risk of stroke from AF.