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Normally, the electrical trigger for the heart to contract is transmitted in a smooth, coordinated manner from the upper chambers to the lower. But in atrial fibrillation, the signal travels chaotically, causing the heart to quiver and either strain to pump or stop.
Also called A-fib, a-fib or afib, atrial fibrillation is the most common irregular heartbeat (arrhythmia) that can cause problems. It can interfere with daily life, as well as lead to stroke and heart failure. But it is also treatable, thanks to our team’s expertise and range of options.
Learn more about what sets our arrhythmia care apart. Or find out more about our EP labs and arrhythmia treatment.
Atrial fibrillation becomes more common with age — more than 10 percent of those older than 80 have the condition. Sometimes doctors cannot determine the reason it appeared. But other causes are known, as well as factors that can increase your risk:
- Heart conditions: Other heart conditions can damage the heart’s electrical system, including high blood pressure or coronary artery disease. A third of patients with a mitral valve problem also have atrial fibrillation. Learn more about mitral valve repair.
- Athletics: Atrial fibrillation is common in athletes and is sometimes triggered by another arrhythmia called supraventricular tachycardia (SVT) that causes fast heartbeats. Learn more about paroxysmal supraventricular tachycardia (PSVT), one type of SVT.
- Heavy drinking: Atrial fibrillation risk is increased by binge drinking (five drinks in two hours for men, or four drinks during that time for women).
- Family history: Your likelihood of developing atrial fibrillation is higher if a relative receives a diagnosis.
- Other conditions: Chronic conditions like diabetes, asthma and thyroid problems can increase your risk. Sleep apnea, which strains the heart, also appears to have a connection.
Atrial Fibrillation Symptoms
Atrial fibrillation can come and go (paroxysmal fibrillation) or persistently remain. Some patients do not feel symptoms, with the condition only detectable when a doctor completes an exam (though they are still at risk for stroke). Others experience:
- Palpitations: uncomfortable feeling that the heart is racing, beating irregularly or fluttering
- Shortness of breath
- Problems exercising
- Chest pain or pressure (a medical emergency — call 911)
The symptoms of atrial fibrillation can resemble other heart conditions. It is important to come to an expert heart center, where an experienced heart team can provide an accurate diagnosis. Learn more about cardiac diagnosis.
Atrial Fibrillation and Stroke
Atrial fibrillation is responsible for 15 to 20 percent of strokes. The condition can cause blood to slow down or pool, increasing the risk for clotting. A clot can then break off, enter the bloodstream and lodge in an artery feeding the brain, causing a stroke. This is possible even if atrial fibrillation does not cause symptoms.
Other complications of atrial fibrillation include:
- Heart failure: the heart beats too fast to fill up with the needed amount of blood (learn more about heart failure)
- Additional heart rhythm problems, such as arrhythmias
Atrial Fibrillation Treatment
Our atrial fibrillation care involves two separate but related approaches:
- Preventing stroke: Some atrial fibrillation patients are at higher risk for stroke than others. Our doctors conduct a thorough evaluation, then choose a possible strategy:
- Lifestyle changes
- Blood thinners (anti-coagulants)
- Surgery: Certain procedures can remove a small part of the heart that increases the risk for stroke. Learn more about atrial fibrillation stroke prevention.
- Regulating the heart’s rhythm or controlling its rate: Our doctors will determine whether arrhythmia treatment is necessary. Options include:
- Regular checkups
- Cardioversion: A safe jolt of electricity from an outside machine resets the heart’s rhythm, though patients may still require medication. Learn more about cardioversion.
- Catheter ablation: A minimally invasive procedure destroys abnormal heart cells to stop wayward signals, when medications and cardioversion do not work, or the arrhythmia returns. It also provides an option for patients who wish to avoid those therapies. Sometimes a pacemaker is also needed. Learn more about catheter ablation or ICDs and pacemakers.
- Cryomaze ablation: Problematic heart cells are frozen during open surgery to block erratic signaling. While patients typically undergo cryomaze during repair for a faulty mitral valve (an often related problem) or when other approaches do not work, the therapy can also provide a highly effective frontline option. Learn more about cryomaze ablation and mitral valve repair.
- WATCHMAN device: The WATCHMAN device is FDA approved as an alternative for patients who cannot tolerate long-term anticoagulation. It is a metal mesh device that blocks the opening of the appendage to prevent blood clot formation there. It is recommended that patients receive short-term anticoagulation until the body heals around the device. The procedure usually takes about an hour and hospital stays are generally about 24 hours after the procedure.