Atrial fibrillation

Atrial fibrillation is an irregular heart rhythm that occurs when the upper chambers of the heart (the atria) beat chaotically, causing the lower chambers (ventricles) to lose their normal coordination. This can lead to palpitations, fatigue, dizziness, breathlessness, or a sensation of a racing or fluttering heartbeat.

AF is the most common heart rhythm disorder, particularly in older adults, but it can affect younger people as well. If untreated, frequent or sustained episodes of AF can strain the heart, increase the risk of heart failure, and raise the chance of stroke.

With expert assessment and tailored treatment, people with AF can manage their symptoms effectively and reduce the risk of complications, helping them maintain a healthy, active life.

Understanding Atrial Fibrillation

Atrial fibrillation (AF) occurs when the heart’s two upper chambers (the atria) beat irregularly and chaotically, disrupting the coordinated rhythm of the lower chambers (the ventricles). Normally, the atria act as the heart’s “pacemaker,” keeping the heartbeat steady and regular. In AF, the electrical signals in the atria become disorganized, causing an irregular and often rapid heartbeat.

This irregular rhythm can cause a range of symptoms, including:

• Palpitations (fluttering, racing, or irregular heartbeat)

• Dizziness or lightheadedness

• Shortness of breath or breathlessness on exertion

• Fatigue or weakness

• Chest discomfort or pain

• Reduced exercise tolerance

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Some people may experience AF without any noticeable symptoms, which is why regular cardiac check-ups are important, especially for those with risk factors.

Who is at Risk?

AF becomes more common with age, affecting up to 20% of people over the age of 80. However, younger adults can also develop AF, often triggered by factors such as:

• High blood pressure or other heart conditions, including heart attacks or valve disease

• Sleep apnea or lung disease

• Thyroid problems or metabolic imbalances

• Certain medications, caffeine, alcohol, or stimulants

• Stress, illness, or infection

• Prior heart surgery

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AF may be intermittent (paroxysmal), persistent, long-standing persistent, or permanent, depending on how frequently and continuously it occurs.

Why AF Matters

If left untreated, AF can have significant consequences:

• Heart strain and heart failure: Frequent or sustained rapid heart rates can tire the heart, reducing its efficiency over time.

• Stroke risk: AF increases the risk of blood clots forming in the atria. If a clot travels to the brain, it can cause a stroke. AF raises stroke risk by 4–5 times, making timely assessment and treatment essential.

  
  

Diagnosing Atrial Fibrillation

Diagnosis involves a combination of clinical assessment and specialized tests. These may include:

• Electrocardiogram (ECG): The primary tool to detect AF.

• Holter monitor or event recorder: Portable devices that track heart rhythm over hours or days.

• Echocardiogram: An ultrasound scan to evaluate heart structure and function.

• Blood tests: To rule out thyroid issues or other metabolic causes.

• Sleep apnea screening: As untreated sleep apnea can trigger or worsen AF.

We will carefully review your medical history, symptoms, and test results to determine the type and severity of AF and guide the most appropriate treatment plan.

Chaotic irregular electrical activity in the heart during atrial fibrillation

Treating Atrial Fibrillation

Treatment for AF focuses on two main goals:

1. Reducing Stroke Risk: Blood thinners (anticoagulants) are commonly prescribed to prevent blood clots and reduce the risk of stroke. Options include:

• Direct Oral Anticoagulants (DOACs): Apixaban, Dabigatran, Rivaroxaban, Edoxaban

• Warfarin: Requires regular blood monitoring to maintain safe levels

  
  

2. Controlling Heart Rate and Rhythm

• Medications: Beta-blockers, calcium channel blockers, or digoxin may be used to control heart rate. Anti-arrhythmic drugs can help restore a normal rhythm.

• Cardioversion: An electrical or drug-induced shock can reset the heart to a normal rhythm.

• Catheter ablation: A minimally invasive procedure to target abnormal electrical “hot spots” in the atria and prevent recurrent AF.

• Surgical options: In selected cases, more invasive procedures such as the Maze operation may be recommended, often alongside other heart surgery.

  
  

Treatment plans are highly individualized, taking into account your symptoms, type of AF, underlying causes, and overall health.

Lifestyle and Risk Factor Management

Optimizing lifestyle factors can significantly improve outcomes in AF, including:

• Maintaining a healthy weight

• Managing blood pressure, diabetes, and cholesterol

• Treating sleep apnea if present

• Reducing alcohol, caffeine, and stimulant intake

• Stress management and regular exercise

A combination of medical therapy, procedures when needed, and lifestyle modification gives many patients excellent control of AF and helps reduce the risk of complications.

Follow-Up and Ongoing Care

Even after successful treatment, AF requires regular follow-up with your cardiologist. Monitoring may include ECGs, Holter checks, and ongoing evaluation of symptoms to ensure the heart rhythm remains stable and stroke risk is minimized. In some cases, repeat procedures may be necessary to maintain normal rhythm.

With modern diagnostics, individualized treatment, and careful management of risk factors, people with AF can lead active, healthy lives with minimal disruption from the condition.