WHAT IS ATRIAL FIBRILLATION?

Atrial fibrillation is the most common type of sustained arrhythmia, occurring when the heart’s upper chambers (atria) beat irregularly and often rapidly.

This irregular rhythm prevents the atria from effectively moving blood into the ventricles, which can lead to blood pooling and an increased risk of stroke.

AF can be caused by a variety of factors, including high blood pressure, coronary artery disease, heart failure, valvular heart disease, cardiomyopathy, thyroid disorders, excessive alcohol intake, and age-related changes in the heart’s electrical system.

There are different types of AF:

• Paroxysmal AF: Episodes start suddenly and stop on their own, usually lasting less than 7 days.

• Persistent AF: Episodes last longer than 7 days and may require treatment to restore normal rhythm.

• Permanent AF: The arrhythmia is continuous and cannot be corrected with treatment, with management focused on controlling heart rate and preventing complications.

WHAT ARE THE SYMPTOMS?

Symptoms can vary widely. Some people experience palpitations, rapid or irregular heartbeat, fatigue, breathlessness, dizziness, or chest discomfort, while others may be asymptomatic. Because of the increased risk of stroke, diagnosis is critical and usually involves an ECG, Holter monitoring, event or loop recorder, and sometimes echocardiography to assess heart structure and function.

WHAT IS THE TREATMENT?

Treatment depends on the type of AF, the underlying cause, and individual risk factors. It often includes medications to control heart rate (beta-blockers, calcium channel blockers) or rhythm (antiarrhythmics), and anticoagulation to prevent stroke. In some cases, procedures such as electrical cardioversion, catheter ablation, or implantation of devices may be recommended. 

Lifestyle modifications- such as reducing alcohol, managing stress, and controlling high blood pressure - can also help prevent episodes and improve outcomes.

These devices are implanted to regulate or monitor heart rhythm. Pacemakers maintain an adequate heart rate, ICDs prevent dangerous arrhythmias, and loop recorders continuously track heart activity for diagnostic purposes.

They are usually indicated for patients with a slow or abnormal heart rhythm, heart block, high-risk ventricular arrhythmias, or unexplained fainting.

Device monitoring, regular follow-ups, and sometimes medication adjustments are essential for ongoing care.