Atrial Fibrillation: The Essential Guide to Symptoms, Causes, and Care

jingxianquah
Mar 8
3 min read

Updated: Mar 26

Your heart is like a finely tuned machine, with an electrical system that keeps everything running smoothly. But what happens when that system goes haywire? In atrial fibrillation (AFib), the heart’s electrical wiring gets disrupted, causing an irregular and often rapid heartbeat. In this post, we’ll explore why this happens, what it means for your health, and how you can take control of your heart’s rhythm

What is Atrial Fibrillation?

Atrial fibrillation (AFib) is a condition where the heart’s upper chambers (the atria) beat irregularly and often too fast. Instead of a steady, coordinated rhythm, the atria quiver or "fibrillate," which can lead to symptoms like:

Palpitations (a racing or fluttering heartbeat)
Shortness of breath
Fatigue
Dizziness or lightheadedness
Chest pain (in some cases)

AFib can also increase the risk of serious complications like stroke and heart failure.

AFib: An Electrical Abnormality in the Atrium

Your heart’s rhythm is controlled by electrical signals that tell it when to beat. In a healthy heart, these signals travel in a coordinated way, creating a steady rhythm. But in AFib, the electrical signals become disorganized, causing the atria to quiver instead of contracting effectively.

These electrical abnormalities disrupt the heart’s ability to pump blood efficiently, leading to symptoms and potential complications.

Electrical abnormality in patients with atrial fibrillation — Left: Electrocardiograph of a patient with normal heart rhythm. Right: Electrocardiograph of a patient with atrial fibrillation

Risk Factors for Atrial Fibrillation

While AFib can occur in anyone, certain factors increase your risk. These include:

Age: The risk of AFib increases as you get older, especially after age 65.
High Blood Pressure: Uncontrolled hypertension is one of the most common risk factors.
Heart Disease: Conditions like coronary artery disease, heart valve problems, or a history of heart attacks can increase your risk.
Obesity: Excess weight, in different ways, can contribute to AFib.
Sleep Apnea: This condition disrupts breathing during sleep and is closely linked to AFib.
Chronic Conditions: Diabetes, thyroid disorders, and chronic kidney disease can increase your risk.
Lifestyle Factors: Smoking, excessive alcohol consumption, and a sedentary lifestyle can also play a role.

Complications of Atrial Fibrillation

If left untreated, AFib can lead to serious complications, including:

Stroke: AFib increases the risk of blood clots, which can travel to the brain and cause a stroke.
Heart Failure: The irregular rhythm can weaken the heart over time, reducing its ability to pump blood effectively.
Fatigue and Reduced Quality of Life: AFib can make everyday activities exhausting and impact your overall well-being.
Cognitive Decline: Some studies suggest a link between AFib and an increased risk of dementia.

Treatment Options for Atrial Fibrillation

The good news is that AFib is manageable, and there are many treatment options available. The goal of treatment is to:

Reduce the risk of stroke.
Maintaining normal heart rhythm.
Maintaining rate control in selected patients

1. Lifestyle Changes

Healthy Diet: Focus on heart-healthy foods like fruits, vegetables, whole grains, and lean proteins, which could help in weight loss.
Regular Exercise: Aim for at least 30 minutes of moderate exercise most days of the week.
Weight Management: Losing weight can significantly reduce AFib symptoms.
Limit Alcohol and Caffeine: Both can trigger AFib episodes in some people.

2. Medications

Rate Control Medications: Help slow down your heart rate (e.g., beta-blockers, calcium channel blockers, digoxin).
Rhythm Control Medications: Help restore and maintain a normal rhythm (e.g., anti-arrhythmic drugs such as flecainide, amiodarone and sotalol).
Blood Thinners: Reduce the risk of stroke by preventing blood clots (e.g., warfarin, DOACs).

3. Procedures

Cardioversion: A procedure that uses electrical shocks or medications to restore a normal rhythm.
Catheter Ablation: A minimally invasive procedure that targets and eliminates the abnormal electrical signals causing AFib.

4. Implantable Devices

Pacemaker: Helps regulate your heart rhythm if medications aren’t effective, when combined with a AV node ablation procedure (ablation to your normal conduction system, rendering your heart dependent on pacemaker.

In all patients, lifestyle changes are highly recommended along with blood thinners if you are deemed high risk for stroke. The choice of rhythm versus rate control or pacemaker with AV node ablation will depend on the discussion with your treating physician and your underlying medical conditions.