Atrial fibrillation (AF) is the most common heart rhythm disturbance encountered by doctors. It can affect adults of any age, but it is more common as people get older. In the over 65 year old age group, it affects about 10% of people.
AF occurs when chaotic electrical activity develops in the upper chambers or atria and causes these chambers to quiver (or 'fibrillate'), rather than beat normally. This can mean that your heart does not pump blood around your body as efficiently as it should. As a result, the atria no longer beat in an organised way, and pump less efficiently. The AV node can stop some of these very rapid impulses from travelling to the ventricles, but the ventricles will still beat irregularly and possibly rapidly.
The cause of AF is not fully understood and men and women are equally susceptible to the disease. It is also age related – the older you become the more likely you are to develop AF. However, it is noted that AF is more likely to occur in patients who have other heart conditions, such as:
· High blood pressure
· Coronary artery disease
· Mitral heart valve disease(caused by rheumatic heart disease,
valve problems at birth, or infection)
· Congenital heart disease (abnormality of the heart since birth)
It can also be associated with:
· Thyroid gland disorders
· Lung cancer and chest infections
· Pulmonary embolism
· Overactive thyroid
· Carbon monoxide poisoning
· Alcohol or drug abuse or misuse
Some AF patients do not experience symptoms, and the AF is only discovered at a routine medical examination or after a health problem. However, for those who do, the most common symptoms are:
· Palpitations (or awareness of the heartbeat), which may be rapid
· Irregular heart beat
· Tiredness/ weakness
· Shortness of breath
· Chest pain
The main risk associated with AF is stroke. This occurs because the atria are fibrillating and not beating in a co-ordinated way. The lack of sufficient contraction means that the blood in the atria becomes stagnant and can form clots. These clots can break off and travel anywhere in the body. If they travel to the brain, they can cause a stroke.
Treatments for atrial fibrillation include:
The best course of treatment will depend on the: