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Atrial Fibrillation: What You Should Know

Atrial fibrillation (Afib) is an arrhythmia, or irregular heartbeat, that occurs when the two top chambers of the heart (atria) beat out of rhythm with the two lower chambers of the heart (the ventricles). If left untreated, this type of rapid, chaotic heartbeat can stretch and weaken the heart muscle. Atrial fibrillation also may restrict blood flow to other parts of the body, increasing the risk for various complications, the most serious being stroke.

Afib, the most common arrhythmia, is estimated to affect 2.7–6.1 million people in the United States. The range is great because the condition is often not diagnosed, usually due to the absence of symptoms in patients who have the condition.

In many cases the cause of AFib may be unknown. It can be the result of damage to the heart's electrical system from other conditions, such as longstanding, uncontrolled high blood pressure or coronary artery disease. AFib is also the most common complication after heart surgery.

AFib may be brief, with symptoms that come and go. It is possible to have an atrial fibrillation episode that resolves on its own, or the condition may be persistent and require treatment. Sometimes AFib is permanent, in which case medicines or other treatments can't restore a normal heart rhythm. Most of the risks and symptoms of AFib are related to how fast the heart is beating and how often rhythm disturbances occur.

Atrial fibrillation can lead to the following complications:

Heart Failure  Atrial fibrillation, especially if not controlled, may weaken the heart and lead to heart failure, a condition in which the heart cannot keep up with its workload. In some cases the heart cannot fill up with enough blood, and in other cases it cannot pump blood to the rest of the body with enough force. Sometimes both problems are present. Heart failure develops over time and can affect one or both sides of the heart.

Stroke  Afib’s chaotic rhythm may form clots from blood that collect in the heart's upper chambers (atria). If a blood clot forms in the atria, it can be pumped out of the heart to the brain, blocking off the blood supply to an artery in the brain, causing a stroke.

The risk of a stroke in atrial fibrillation increases with age, depending on other conditions such as high blood pressure, diabetes, a history of heart failure or previous stroke. Certain chronic conditions such as, sleep apnea, obesity, diabetes, thyroid disorders, chronic kidney disease, or lung disease may increase the risk of atrial fibrillation. In some cases, alcohol consumption can trigger an episode of Afib, and binge drinking poses an even higher risk. Certain medications can greatly lower the risk of a stroke or the damage to other organs caused by blood clots.

One study found that moderate physical activity is safe and effective for people with atrial fibrillation. Physical activity also helped improve their quality of life and increase their ability to exercise and participate in daily living activities. However, research is conflicting regarding the effects of vigorous physical activity in people with atrial fibrillation. Although it is a serious medical condition, most people diagnosed with Afib can lead healthy, active lives. Treatments may include a combination of lifestyle changes and medication, and in some cases surgery or a pacemaker may be required.

Along with adopting a heart-healthy lifestyle, patients with Afib should see a health care provider to determine treatment needs and options. UAB Heart & Vascular Services delivers optimal patient care for heart rhythm disorders. Our physicians are leaders in the treatment of heart arrhythmias such as atrial fibrillation, and are part of a program that carries out pioneering work in atrial fibrillation and advanced pacemaker and cardioverter defibrillator design. Our academic medical center performs more than 600 heart rhythm-related procedures each year, and our success in treating all types of complex arrhythmias is well-documented.

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