Atrial Fibrillation

Disorganized, rapid electrical discharges in the atria (top chambers of the heart), creating an irregular heartbeat in the atria that often does not coordinate with heartbeat in the ventricles (bottom chambers of the heart).

Atrial arrhythmias are more common in congenital heart diseases that cause the top chambers of the heart to enlarge, such as atrial septal defects after surgical repair, Tetralogy of Fallot, classic and lateral tunnel Fontan circuits, and transposition of the great arteries after Senning/Mustard repair. Leaking of the valves that separate the atria from the ventricles can cause the atria to become large over time, and increase the risk of atrial arrhythmias.

Signs and symptoms:

The symptoms of atrial arrhythmias vary, ranging from no symptoms at all to

  • shortness of breath
  • palpitations (heart racing, skipping, or fluttering feelings)
  • dizziness
  • fatigue

If the atrial arrhythmia is not under control, weakening of the heart muscle and/or blood clot formation in the heart can occur, increasing the risk of stroke.


12 lead ECG can determine if you are in Atrial Fibrillation.


Management of atrial fibrillation is directed at controlling fast heart rates that can lead to symptoms and overall weakening of the heart muscle and avoiding blood clots that can lead to stroke. A variety of cardiac medications and blood thinners may also be prescribed by your cardiologist. On occasion, a cardioversion (a controlled electrical shock while under sedation) may be necessary to restore a patient’s normal rhythm. In select patients either an electrophysiology study (EPS) and catheter ablation or surgical ablation (see Basic EP Fact Sheet) can be used to treat the problem and cauterize the sites of abnormal electrical discharges. Your cardiologist will discuss the treatment options with you.

Lifestyle changes:

Ongoing close management with your cardiologist/electrophysiologist is essential. Depending on rhythm control and medical management, lifestyle changes may be individualized.

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