Atrial fibrillation (patient information)

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Atrial fibrillation

Overview

What are the symptoms?

What are the causes?

When to seek urgent medical care?

Treatment options

Where to find medical care for Atrial fibrillation?

What to expect (Outlook/Prognosis)?

Possible complications

Atrial fibrillation On the Web

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CDC on Atrial fibrillation

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Directions to Hospitals Treating Atrial fibrillation

Risk calculators and risk factors for Atrial fibrillation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Prashant Sharma

Overview

Atrial fibrillation/flutter is a heart rhythm disorder (arrhythmia). It usually involves a rapid heart rate in which the upper heart chambers (atria) contract in a very disorganized and abnormal manner. Instead of contracting regularly the small chamber has chaotic electrical impulses that cause the heart to beat in an irregularly irregular fashion.

What are the Symptoms of Atrial Fibrillation?

You may not be aware that your heart is not beating in a normal pattern, especially if it has been occurring for some time.

Symptoms may include:

Note: Symptoms may begin or stop suddenly.

What Causes Atrial Fibrillation?

Arrhythmias are caused by a disruption of the normal electrical conduction system of the heart.

Normally, the four chambers of the heart (two atria and two ventricles) contract in a very specific, coordinated way. The electrial impulse that signals your heart to contract in a synchronized way begins in the sinoatrial node (SA node). This node is your heart's natural pacemaker.

The signal leaves the SA node and travels through the two upper chambers (atria). Then the signal passes through another node (the AV node), and finally, through the lower chambers (ventricles). This path enables the chambers to contract in a coordinated fashion.

In atrial fibrillation, the atria are stimulated to contract very quickly and differently from the normal pattern. The impulses are sent to the ventricles in an irregular pattern. This makes the ventricles beat abnormally, leading to an irregular (and usually fast) pulse. In atrial flutter, the ventricles may beat very fast, but in a regular pattern. If the atrial fibrillation/flutter is part of a condition called sick sinus syndrome, the sinus node may not work properly and the heart rate may alternate between slow and fast. As a result, there may not be enough blood to meet the needs of the body.

Atrial fibrillation can affect both men and women. It becomes more common with increasing age.

Causes of atrial fibrillation include:

When to Seek Urgent Medical Care

Call your health care provider if you have symptoms of atrial fibrillation or flutter.

Diagnosis

The health care provider may perform the following tests for this condition:

Tests to find underlying heart diseases may include:

Treatment Options

Treatment Strategies

Basic treatment strategies involve the following:

In certain cases, atrial fibrillation may need emergency treatment to reverse the heart back into normal rhythm. This treatment may involve electrical cardioversion or intravenous (IV) drugs such as dofetilide, amiodarone, or ibutilide. Drugs are typically needed to keep the pulse from being too fast.

Long-term treatment varies depending on the cause of the atrial fibrillation or flutter. Medications to slow the heartbeat may include:

Blood thinners such as heparin and warfarin (coumadin) reduce the risk of a blood clot traveling in the body causing conditions such as a stroke. Because these drugs increase the chance of bleeding, not everyone will use them. Antiplatelet drugs such as aspirin or clopidogrel may also be prescribed. Your doctor will consider your age and other medical problems to decide which drug is best. In general, patients who have had a prior stroke should not use aspirin and clopidogrel together.

Some patients with atrial fibrillation, rapid heart rates, and intolerance to medication may need a catheter procedure on the atria called radiofrequency ablation.

For some patients with atrial flutter, radiofrequency ablation can cure the arrhythmia, and this is the treatment of choice. Some patients with atrial fibrillation and a rapid heart rate may need the radiofrequency ablation done directly on the AV junction (the area that normally filters the impulses coming from the atria before they move on to the ventricles).

Ablation, a procedure that disconnects or breaks the electrical pathway between the upper chambers (atria), lower chambers ventricles, and the AV junction may cause a complete heart block. This condition needs to be treated with a permanent pacemaker.

Where to Find Medical Care for Atrial Fibrillation?

Directions to Hospitals Treating Atrial fibrillation

What to Expect (Outlook/Prognosis)?

The disorder is usually controllable with treatment. Many people with atrial fibrillation do very well.

Atrial fibrillation tends to become a chronic condition, however, it may relapse even with treatment.

Complications

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000184.htm

References

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