Atrial Fibrillation

What is Atrial Fibrillation?

Atrial Fibrillation (also known as AF) is the most common type of heart arrhythmia. In AF the electrical signals in the chambers of your heart become chaotic and disorganised, making them contract very rapidly and in an irregular way. This is known as fibrillation.

This fast, irregular rhythm prevents the heart from pumping effectively and the circulation of blood can be impaired.

Some types of AF can be treated by a process called cardioversion, a procedure which uses a controlled electric shock to you heart, from a machine called a defibrillator, to restore your normal heart rhythm.

The different types of Atrial Fibrillation:

• Paroxysmal atrial fibrillation comes and goes and usually stops within 48 hours without any treatment.
• Persistent atrial fibrillation lasts for longer than 7 days and can be treated with drugs or by cardioversion to help the heart return to beating normally.
• Permanent or chronic atrial fibrillation lasts for a long time (usually longer than a year). Cardioversion is rarely used in this case and is not usually successful. Drug treatment can be used to help control the heart rate.
• Acute-onset atrial fibrillation is an episode of AF that either starts suddenly (for the first time) or when existing AF becomes suddenly worse. This kind of AF can cause potentially dangerous symptoms (e.g. very fast heart rate) which may need to be treated in hospital.

Symptoms of Atrial Fibrillation

Some people have no symptoms and AF is only discovered when a nurse or doctor feels your pulse and finds it to be fast and irregular.

When the heart beats fast and in an irregular way it cannot work efficiently, and the following symptoms may occur:

• Dizziness
• Tiredness
• Chest pain
• Shortness of breath
• Palpitations (increased awareness of your heartbeat)

If you notice a sudden change in your heartbeat and have chest pain, you should always seek urgent medical advice.

What are the risks of Atrial Fibrillation?

• Stroke: The main risk of AF is causing a stroke. When the atria are not pumping effectively, they do not always empty completely, leaving a pool of blood in the chamber. This blood can become sludgy and may clot. If a blood clot enters the blood stream it can lead to a stroke. You will usually be prescribed a blood thinning drug (e.g. warfarin, heparin or aspirin) to try and prevent this.
• Heart failure: Over time AF can weaken the heart. When the heart muscle cannot meet the body’s demands for blood and oxygen the body develops a range of different symptoms. When this happens, it is referred to as heart failure because of the failure of the heart to work efficiently.

Causes of Atrial Fibrillation

For some people, the cause of AF is unknown. However sometimes AF develops along with other medical conditions such as:

• Heart conditions such as:
  • High blood pressure
  • Coronary heart disease (especially after a heart attack or heart surgery)
  • Heart valve disease
  • Congenital heart disease
  • Cardiomyopathy
• Lung conditions such as:
  • Pulmonary embolism
  • Asthma
  • Emphysema
  • Chronic obstructive pulmonary disease (COPD)
  • Pneumonia
  • Lung cancer
• An overactive thyroid gland
• Diabetes
• Imbalances in the blood e.g., potassium, calcium

What triggers Atrial Fibrillation?

There are a variety of situations that can trigger an episode of, or contribute to, AF:

• Drinking excessive amounts of alcohol, particularly ‘binge drinking’
• Being overweight
• Drinking a lot of caffeine, e.g., coffee, tea and energy drinks
• Taking recreational drugs, particularly those that stimulate the heart e.g. amphetamines or cocaine
• Smoking

Maintaining a healthy lifestyle

Learning to recognise your individual trigger factors and reducing, or avoiding, them can sometimes help to minimise your symptoms of AF. This could mean some significant changes to your way of living and changing your daily habits, such as stopping smoking or cutting out alcohol.

This can be a difficult transition and telling your loved ones that you’re undertaking it means that they can support you and even get involved in making healthier choices. Make sure that you get in the habits of drinking your daily recommended amount of water, eating healthily and staying active wherever possible.

Visit our Living with a Heart Condition section for more information about how to manage your condition at home, how to stay well and reduce your risk of future heart conditions.

Call our Advice Line for free on 0808 801 0899 or text NURSE to 66777 if you’d like information on support groups, AF or even just a trained listening ear. We’re here to support you and help you to build a healthier life.