Atrial Fibrillation: Types, Causes & Modern Treatment Options

Your heart's upper chambers (atria) beat irregularly instead of maintaining a normal rhythm in atrial fibrillation. The atria quiver rather than contract well, and this makes blood pool. Blood flow gets disrupted by this chaotic electrical activity, which can form dangerous clots. AFib is the most common heart arrhythmia that doctors treat. 

Here's what typically causes AFib:

• Heart tissue or electrical system damage

• High blood pressure (causes about 1 in 5 cases)

• Heart disease (valve problems, heart failure)

• Thyroid disorders (especially with hyperthyroidism)

• Sleep apnea

These factors can increase your AFib risk:

• Age (risk goes up after 65)

• Obesity

• Alcohol consumption

• Smoking

• Existing heart conditions

• Family history

• Physical inactivity

Doctors often find AFib during routine check-ups because some people don't show any symptoms. People with AFib often experience:

• Irregular heartbeat or palpitations

• Fatigue and weakness

• Shortness of breath

• Dizziness or lightheadedness

• Chest pain or pressure

• Limited exercise capacity

AFib doubles your death risk and makes strokes five times more likely. Your heart can't pump blood well with irregular beats. This leads to:

• Blood clots that might cause strokes

• Heart failure from weakened heart muscle

• Poor blood flow to vital organs

• Cognitive decline and dementia

Get medical help right away if:

• You have your first AFib episode

• Your resting heart rate goes above 120 beats per minute

• You notice stroke signs (face drooping, arm weakness, speech problems)

• You feel chest pain, severe breathing problems, or faintness

Note that regular check-ups are crucial because even AFib without symptoms raises your stroke risk.

Doctors need specific tests to spot heart rhythm patterns in AFib patients. The process starts with a physical exam where doctors check the pulse, blood pressure, and listen to heart sounds. Several diagnostic tests help confirm AFib:

• Electrocardiogram (ECG/EKG): This key test records the heart's electrical activity and shows irregular rhythms typical of AFib

• Portable monitors: These help track occasional episodes:

  • Holter monitors track continuously for 24-48 hours

  • Event recorders capture heart activity for up to 30 days

  • Implantable loop recorders can monitor for up to three years

• Echocardiography: Sound waves create heart images that show its structure and function, which helps spot possible complications

Blood tests also help identify conditions like thyroid disorders or electrolyte imbalances that might set off AFib.

The treatment's main goal is to prevent blood clots, control heart rate/rhythm, and tackle why it happens. Today's treatment approaches include:

Medications:

• Blood thinners (anticoagulants): These prevent strokes and blood clots. Patients can take warfarin or newer direct-acting oral anticoagulants (DOACs) 

• Rate control medicines: Beta blockers, calcium channel blockers, and digoxin help bring down rapid heart rates

• Rhythm control medicines: These bring back and keep a normal heart rhythm

Procedures:

• Cardioversion: Low-energy electrical shocks or medications help restore normal rhythm.

• Catheter ablation: This destroys tissue that causes irregular signals. 

• Left atrial appendage closure: This stops clots from forming in the heart's small chamber sac

Advanced options include the Maze procedure that blocks abnormal signals with scars, and pacemaker implantation. Weight management and cutting back on alcohol are also key parts of a comprehensive treatment plan.

Atrial fibrillation ranks as one of the most common and serious heart conditions worldwide. 

AFib comes in different types - paroxysmal, persistent, long-standing persistent, and permanent. This knowledge helps patients identify their condition better. The symptoms can vary a lot. Some people feel obvious signs like palpitations and fatigue. Others only find out about their condition during regular check-ups.

Medical science has made great progress in managing AFib. Quick diagnosis is vital to make treatment work. People should seek medical help right away if they notice unusual heart rhythms or worrying symptoms. Even AFib without symptoms needs proper care to stop serious complications.

AFib treatment works best with an integrated approach. Medical treatments work, among other changes, like managing weight, limiting alcohol and staying active. AFib brings challenges, but most patients can live well with proper care. Success comes from working closely with doctors to create a customised plan that fits each patient's needs and risks.

FAQs

1. What is atrial fibrillation and how serious is it?

Atrial fibrillation occurs when your heart's upper chambers beat chaotically and don't sync with the lower chambers. This condition is the most common type of cardiac arrhythmia. AFib can be dangerous because:

• Your risk of stroke becomes five times higher than that of people without AFib

• You might develop blood clots, heart failure and cognitive problems

• The death risk doubles compared to people with normal heart rhythms
  

  2. What are the main causes of atrial fibrillation?

AFib develops due to several factors:

• Damage to the heart tissue or its electrical signalling system

• Heart conditions like valve disease and heart failure

• High blood pressure

• Thyroid problems, especially an overactive thyroid

• Sleep apnea

• Age-related changes in heart tissue

  
  3. Can stress or anxiety cause AFib?

Stress and anxiety can trigger AFib episodes, and this works both ways:

• Your sympathetic nervous system activates with stress, which can trigger AFib

• Anxiety lowers heart rate variability and vagal tone, creating perfect conditions for AFib

• Your heart tissue can get damaged over time from stress hormones

• The condition itself often makes you more anxious, which creates a tough cycle

4. What does AFib feel like in the chest?

People experience AFib differently, but common sensations include:

• A fluttering or "fish flopping" feeling in the chest

• Pounding or thumping sensations

• Sudden racing heartbeat

• Skipped or irregular beats

• Pressure or discomfort in the chest

5. How is AFib different from a heart attack?

These conditions share some symptoms but are fundamentally different:

• AFib affects your heart's electrical system, causing irregular rhythm

• Heart attacks happen when blood can't flow to the heart muscle

• You'll mainly feel palpitations and tiredness with AFib

• Heart attacks usually cause pain in your arms, jaw, or back with nausea

• You need immediate emergency care for a heart attack

6. Can atrial fibrillation go away on its own?

Sometimes AFib resolves without treatment:

• Paroxysmal AFib episodes stop by themselves within 7 days

• You might experience spontaneous remission, but it's rare

• Paroxysmal AFib usually progresses to persistent forms without treatment

• About 10-20% of paroxysmal cases become persistent AFib within a year