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Complete Guide to Atrial Fibrillation

Atrial fibrillation is the most common heart rhythm disorder. The condition is commonly referred to as AFib and sometimes AF. It affects an estimated 6 million people in the United States, and that number is projected to double by 2030. 

There are two primary types of AFib. In paroxysmal atrial fibrillation, the irregular rhythm stops, and the heart returns to normal rhythm on its own. In persistent atrial fibrillation, the heart stays in the irregular rhythm unless treated.

During AFib, the upper chambers of the heart (called the atria) do not beat regularly and, thus, do not efficiently move blood out of the heart. As blood pools in the heart, the risk of blood clots increases, and any clots that form can potentially travel to the brain and cause a stroke. Overall, atrial fibrillation is a treatable condition, but it’s helpful to know the symptoms, risk factors, and treatment options available. 

What are the symptoms of atrial fibrillation?

Symptoms of atrial fibrillation include heart palpitations, shortness of breath, fatigue, light headedness, dizziness, and sometimes passing out. AFib can impact an individual’s overall daily life because they don’t feel their best and often lack energy to do regular activities. While AFib on its own is not generally a life-threatening condition, it puts patients at a greater risk for stroke and can also increase the risk for heart failure.

What are the risk factors for atrial fibrillation?

There are many risk factors for atrial fibrillation, including:  

  • Age
  • Prior heart disease
  • Family history
  • High blood pressure
  • Obesity
  • Thyroid problems
  • Sleep apnea
  • Diabetes
  • Kidney disease
  • Lung disease
  • Excessive alcohol intake

Age is one of the most common risk factors. Because women typically live longer than men, atrial fibrillation is more common in women. 

What causes atrial fibrillation?

There are many common causes for atrial fibrillation, but AFib is usually caused by damage to heart tissue or the heart’s electrical system, though the cause remains unknown for some individuals. Potential heart-related issues that can lead to atrial fibrillation include:

Some causes of atrial fibrillation are reversible through lifestyle changes or better management of other health conditions. 

How is atrial fibrillation diagnosed?

Symptoms of atrial fibrillation are similar to the symptoms of many other irregular heart rhythms. To diagnose atrial fibrillation, your physician will ask you questions about your symptoms and your personal and family health history and then conduct a physical exam and order diagnostic tests.

The first diagnostic test used is typically an electrocardiogram (ECG or EKG), which is an in-office test that evaluates the heart rhythm. Because AFib can be an intermittent irregular heart rhythm, an ECG alone may not be able to diagnose it. Your doctor may recommend a Holter monitor, which is worn for 24 to 48 hours, to gather additional information about how often atrial fibrillation occurs and how long the irregular rhythm lasts.  

What are the treatment options for atrial fibrillation?

There are multiple treatment options available for atrial fibrillation, and physicians at Oklahoma Heart Hospital regularly use new treatment options for AFib. Your physician will recommend options based on your specific health history, symptoms, and severity of your condition. 

  • Blood thinners are prescribed to patients with atrial fibrillation to reduce the risk of stroke associated with the condition. Patients typically continue to take blood thinners in combination with other treatments.
  • Antiarrhythmic medications, which can help prevent AFib from happening, are often the first line of treatment. There are many types of antiarrhythmic medications, and it may take trying more than one to find the best fit. 
  • Cardioversion, also knowns as electrical cardioversion, can help restore the heart to normal rhythm during an episode of AFib. Some people’s heart rhythm returns to normal and stays that way following cardioversion, while others do not. 
  • Catheter ablation is a treatment option used when medication and cardioversion are unsuccessful. Catheter ablation includes both radiofrequency ablation and cryoablation to identify and destroy the tissue causing the irregular heart rhythm.
  • Surgical ablation intentionally creates scar tissue to disrupt the irregular rhythm. There are two main types of surgical ablation: convergent ablation and Cox-Maze IV ablation.