Atrial Fibrillation

Atrial fibrillation (AFib) is a type of heartbeat that is irregular or fast (rapid). If you have this condition, your heart beats without any order. This makes it hard for your heart to pump blood in a normal way. Having this condition gives you more risk for stroke, heart failure, and other heart problems.

AFib may start all of a sudden and then stop on its own, or it may become a long-lasting problem.

What are the causes?

This condition may be caused by heart conditions, such as:

  • High blood pressure.
  • Heart failure.
  • Heart valve disease.
  • Heart surgery.

Other causes include:

  • Pneumonia.
  • Obstructive sleep apnea.
  • Lung cancer.
  • Thyroid disease.
  • Drinking too much alcohol.

Sometimes the cause is not known.

What increases the risk?

You are more likely to develop this condition if:

  • You smoke.
  • You are older.
  • You have diabetes.
  • You are overweight.
  • You have a family history of this condition.
  • You exercise often and hard.

There are different types of AFib:

  • Paroxysmal AF -  AFib that occurs sometimes and then stops. AFib stops by itself and the heart returns to normal rhythm. AFib may last for seconds, minutes, hours, or days before the heart returns to its normal rhythm. People with this type of AFib usually have more symptoms than others. As the heart goes in and out of AFib, the pulse rate may change from slow to fast and back again in short periods of time.
  • Persistent AF - AFib that does not stop by itself. Medications or a special type of electrical shock (called cardioversion) is used to help the heart return to normal rhythm. If no treatment is given, the heart will stay out of rhythm.
  • Long standing persistent AF (formerly known as Permanent AF) - AFib that cannot be corrected. Medications and controlled electrical shock cannot help return the heart to normal rhythm.

Symptoms and Signs

Some people with AFib feel no symptoms at all. They do not know they have AFib or that there is a problem. Others can tell as soon as it happens. The symptoms of AFib are different for each person.

This depends on age, the cause of the AFib (such as heart problems or other diseases), and on how much AFib affects the pumping of the heart. Symptoms include:

  • Heart palpitations (feeling like your heart is racing, pounding, or fluttering)
  • Feeling overtired or a lack of energy 
  • Pulse that is faster than normal or changing between fast and slow and feels irregular
  • Shortness of breath
  • Trouble with everyday activities or exercise
  • Chest pain, pressure, discomfort or tightness
  • Dizziness, lightheadedness, or fainting

The symptoms of atrial fibrillation may be exaggerated by other conditions such as infection, sepsis, hypoxia due to respiratory illness, hemorrhage and any stress, either physical or emotional.

 

Diagnosis

Several tests can be done to check for a fast or irregular heartbeat. Your doctor may order these tests if you are having signs or symptoms of a heart problem.

An ECG is a snapshot of your hear's electrical activity. Stickers (electrodes) are attached to your chest, arms, and legs. These electrodes measure the rate and rhythm of your heart.

A Holter monitor is a portable ECG. It can be worn for several days. Stickers (electrodes) are placed on your chest and are then connected to a small recording machine that is usually worn around the waist. It records the electrical activity of your heart for your doctor to review later.

A mobile cardiac monitor is worn for up to 30 days. It records your heart’s beat when it is in normal and abnormal rhythm. The results are automatically sent to your doctor. Your doctor uses this information to evaluate your symptoms to determine what is causing the abnormal rhythm.

An event monitor is a portable ECG that is used for patients who have an irregular heart rhythm every once in a while. You will carry the monitor with you at all times and attach it to your chest when you feel symptoms. This lets your doctor check your heart rhythm at the time of your symptoms.

An echocardiogram uses sound waves to produce images of your heart. This test allows your doctor to see how your heart muscle is moving and pumping blood.

A TTE is a standard non-invasive (no incisions or cuts) echocardiogram that gives your doctor a picture of your beating heart. An imaging device, called a transducer, gives off and reads sound waves. The imaging device records the sound waves bouncing off the walls and valves (echoes) in your heart. A computer then creates a video of your heart. This video can show the size of your heart, how well your heart is working, if the heart valves are working, and if there are blood clots in your heart.

A TEE is often done when the doctor needs to get a good picture of the back of your heart. To get a clear picture, a probe is placed down the esophagus (the tube that connects your mouth to your stomach). The esophagus passes right behind the heart. Once the probe is in place, it works the same way as a TTE described above.

Cardiac CT uses an X-ray machine and a computer to take clear, detailed pictures of the heart. During a cardiac CT, an X-ray machine will take pictures of your heart and chest. A computer will put the pictures together to make a three-dimensional (3D) picture of your heart and chest.

A cardiac MRI uses radio waves, magnets, and a computer to create pictures of your heart. Cardiac MRI creates detailed pictures of your heart as it is beating. The MRI will create snapshots as well as videos. Doctors use cardiac MRI to see the beating heart, the parts of the heart, and how the heart is working.

Related Resources

Watch this video to learn more about Atrial Fibrillation.

 

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