Atrial fibrillation (AF) is the most common type of cardiac arrhythmia, characterized by an irregular and often rapid heart rhythm originating in the atria. AF can significantly increase the risk of stroke, heart failure, and other cardiovascular complications if not properly managed.
What is Atrial Fibrillation?
In AF, the atria (upper chambers of the heart) beat chaotically and irregularly, causing the heart to pump blood inefficiently. This irregular rhythm can be paroxysmal (intermittent), persistent, or permanent, depending on its duration and response to treatment.
Causes and Risk Factors
Atrial fibrillation often occurs due to underlying heart or systemic conditions. Common causes include:
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Hypertension (high blood pressure) – leading contributor to AF
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Coronary artery disease – reduces blood flow to the heart
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Valvular heart disease – especially mitral stenosis or regurgitation
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Heart failure – can trigger or worsen AF
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Hyperthyroidism – excess thyroid hormone can increase heart rate
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Chronic lung disease – such as COPD
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Obesity and sleep apnea – increase AF risk
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Excess alcohol or stimulant use
Symptoms of Atrial Fibrillation
Some patients with AF may be asymptomatic, but common symptoms include:
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Palpitations (fluttering or rapid heartbeat)
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Fatigue and weakness
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Shortness of breath
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Dizziness or lightheadedness
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Chest discomfort or pain
Note: AF may sometimes present for the first time with a stroke due to blood clot formation in the atria.
Complications of AF
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Stroke: AF increases the risk of thrombus formation in the atria, which can travel to the brain.
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Heart failure: Inefficient heart pumping may lead to fluid retention and shortness of breath.
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Reduced quality of life: Fatigue, palpitations, and anxiety may affect daily activities.
Diagnosis of Atrial Fibrillation
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Electrocardiogram (ECG): Confirms irregularly irregular rhythm and absent P waves.
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Holter monitor: Continuous ECG recording for intermittent AF.
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Echocardiography: Evaluates heart structure and function, including atrial size.
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Blood tests: Check thyroid function, electrolytes, and other contributing factors.
Management of AF
Management focuses on rate control, rhythm control, and stroke prevention.
1. Rate Control
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Beta-blockers (e.g., metoprolol)
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Calcium channel blockers (e.g., diltiazem, verapamil)
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Digoxin (for selected patients)
2. Rhythm Control
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Antiarrhythmic medications: Amiodarone, flecainide, or sotalol
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Electrical cardioversion: Restores normal rhythm in acute cases
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Catheter ablation: For recurrent or drug-resistant AF
3. Stroke Prevention
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Anticoagulants: Warfarin, apixaban, rivaroxaban, or dabigatran
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Risk assessment with CHA₂DS₂-VASc score guides anticoagulation therapy
4. Lifestyle Modifications
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Avoid alcohol and stimulants
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Maintain healthy weight
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Treat sleep apnea if present
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Manage hypertension, diabetes, and heart disease
Conclusion
Atrial fibrillation is a common but serious heart rhythm disorder. Early diagnosis, proper management, and stroke prevention strategies are essential to reduce complications and improve quality of life. Patients with AF should work closely with their healthcare providers to control heart rate, maintain rhythm, and minimize risk factors.
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