Atrial Fibrillation

What is Atrial Fibrillation?

Patients will feel atrial fibrillation as palpitations – when you can feel your heart beating, often very fast. This can come and go or can be there all the time. Some people with this feel very unwell and even faint. Others are aware of their heart racing but it does not make them feel unwell. It is the most common heart rhythm problem that we see.

The technical part

There are 4 chambers in the heart – the top 2 chambers are called the atria. These normally  beat regularly at an average of 70 beats a minute. Sometimes this goes wrong and they “twitch” (fibrillate) rather than beat in an organised way. There is a node between the top heart chambers and bottom heart chambers (ventricles) and this stops all the electrical impulses generated by the twitching from being sent to the ventricles, which are the main heart pumping chambers. However, as the impulses are irregular, and it is these that trigger the ventricles,  the heartbeat becomes irregular.  It also can be very fast, at the atria can fibrillate up to 500 times a minute! Luckily the node filters these signals, but the heart rate can go up to 200 beats a minute.

Why does this matter?

When the atria aren’t beating regularly, the blood passing through them gets disturbed. If this goes on, this can lead to clots forming in the atria as there may be areas in the heart where the blood stays still. It is possible that these clots can break away and travel around the body, learning to a stroke. It also can make you feel tired, lower your blood pressure, and make you feel dizzy or short of breath.

Can it be prevented?

Smoking, drinking too much caffeine and alcohol all can trigger atrial fibrillation. Sometimes it is caused by other heart conditions like a leaky heart valve or narrowed coronary arteries. High blood pressure that isn’t controlled can also lead to atrial fibrillation.

How is atrial fibrillation treated?

It depends on many things – you may need blood thinners to make sure you do not get a clot forming in the heart, which will reduce the chance of you having a stroke. You may be given a medicine to control the heart beat, which will either steady the heart rhythm or slow it down. You may also be asked to have a very short procedure where an electric shock is applied to the heart to put it back into a normal rhythm. This is done under a short acting anaesthetic so it is not painful and is done as a day case at the hospital. Occasionally you may need to have a different procedure where a small tube is put in the heart and the area of the heart triggering the problem is destroyed.

Next steps

See your doctor if you develop an irregular heartbeat. Stop smoking and reduce the amount of caffeine and alcohol you are taking. Atrial fibrillation is not usually life threatening but can be uncomfortable. If blood thinning medicines are needed it is best to start is early so you are not putting yourself at risk of stroke.

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Further information can be found on the BHF website