What is Atrial Fibrillation (AFib)?
What is Atrial Fibrillation (AFib)?Atrial fibrillation (also known as AFib or AF) causes irregular heart rhythm due to chaotic electrical activity in the heart’s top chambers. Atrial fibrillation is the most common sustained cardiac arrhythmia, and its incidence is increasing.
Arrhythmias, including AFib, are caused by disturbances in the electrical signaling in the heart. The normal heart rate for an adult ranges from about 60 to 100 heats per minute. However, this can vary greatly depending on the individual. Atrial fibrillation can cause the heart to beat much faster than this, sometimes over 150 beats per minute, and may cause chest pain. This is usually experienced as palpitations, but sometimes AFib can have no symptoms.
An electrocardiogram (EKG) detects and records the heart’s electrical activity. It is used to confirm atrial fibrillation since it allows doctors to see problems with heart rhythm. Many consumer wearables can screen for and detect AFib, but these need to be confirmed by qualified medical personnel.
During AFib, due to chaotic electrical activity, sometimes insufficient blood is pumped to the lungs and body. This can cause dizziness, tiredness, and the feeling of the heart fluttering or skipping beats.
Over time episodes of AFib can last longer and occur more often, so it should be treated. Atrial fibrillation puts patients at higher risk for stroke and heart failure.
Types of Atrial Fibrillation
TypesAtrial fibrillation can be a chronic or an acute condition. Patients can start with one type of AFib that progresses to another type. There are four types of atrial fibrillation:
- Paroxysmal AFib: This type of atrial fibrillation comes and goes spontaneously, and most episodes resolve on their own within 24 hours. The irregular heartbeat, however, may last anywhere from several seconds to a week. Lifestyle changes, such as eliminating alcohol, weight loss, sleep apnea screening and treatment, and reducing stress may be advised.
- Persistent AFib: This type of AFib begins spontaneously, lasts at least seven days, and may require medical intervention to stop the episodes. Medical intervention may include cardioversion, a procedure when a synchronized electrical impulse is given to reset the heart back into a regular heart rhythm. Preventative measures, such as lifestyle changes and medication, may be indicated.
- Long-standing persistent AFib: This type of AFib continues for at least a year uninterrupted. It is associated with structural damage and remodeling of the heart, making routine medicines and procedures to maintain sinus rhythm less effective.
- Permanent AFib: This type of AFib results in the atria remaining in AFib permanently. The doctor and patient make the decision to stop treatment efforts to maintain a regular rhythm, leaving the heart in a state of AFib all the time. Patients will still take rate control medications and blood thinners. Permanent AFib can lower quality of life and increase the likelihood of future cardiac events.
Signs & Symptoms of Atrial Fibrillation
SymptomsNot all individuals experiencing atrial fibrillation will experience symptoms. Some people feel completely normal and are unaware of their condition until it is found through a routine EKG (electrocardiogram). Those who do experience symptoms are often affected in different ways.
Any of the following atrial fibrillation symptoms may be present in any combination:
- Heart palpitations (a feeling of racing, thumping, or flip-flopping)
- Extreme fatigue (having little-to-no energy – unusually tired)
- Feeling short of breath or weak with little physical activity
- Chest pain or discomfort
- Dizziness, lightheadedness, or fainting
- Confusion
- Low blood pressure
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What Causes Atrial Fibrillation?
CausesAtrial fibrillation occurs when the heart beats out of a normal rhythm. Very fast and irregular heartbeats characterize this arrhythmia. Usually the result of multiple factors, the exact cause of AFib is unknown. Aging is the most prominent risk factor for developing AFib. The presence of other conditions, both cardiac and non-cardiac, as well as structural damage to the heart, may cause atrial fibrillation.
Although some people develop AFib without having other heart problems or damage, the following conditions may be causes of atrial fibrillation:
- Hypertension (high blood pressure)
- Valvular disease (specifically of the mitral valve)
- Cardiomyopathy (a disease of the heart muscle)
- Diabetes
- Thyroid disease
- Coronary artery disease
It is important to note that there is no identifiable cause of atrial fibrillation for many people.
Risk Factors
Risk FactorsThere are genetic, environmental, and behavioral risk factors for atrial fibrillation. Behavioral risk factors, such as smoking, stress, and alcohol consumption, can often be controlled through lifestyle changes. Researchers are conducting genetic studies to determine the genetic risk factors for AFib.
Risk factors for atrial fibrillation include the following:
- Advancing age
- High blood pressure
- Obesity
- Heart disease
- Thyroid disease
- Diabetes
- Family history
- Any alcohol consumption
- Smoking
- Stress
Prevention
PreventionSince the exact causes of atrial fibrillation are unknown, the condition is difficult to prevent. However, lifestyle choices can help keep AFib at bay, restore normal rhythm, or, at the very least, maintain your condition so you can get the most out of treatment.
Lifestyle choices for the prevention of atrial fibrillation include:
- Stopping smoking/avoiding cigarettes
- Lowering high blood pressure
- Losing weight and/or maintaining a healthy body weight
- Consuming a healthy diet
- Getting enough quality sleep and/or treating obstructive sleep apnea
- Practicing self-care to avoid stress as much as possible
- Limiting or eliminating alcohol consumption
Trust NewYork-Presbyterian for Heart Arrhythmia Care
Learning more about your diagnosis and treatment options is your first step if you are experiencing any symptoms of AFib. NewYork-Presbyterian’s arrhythmia specialists include cardiologists, heart surgeons, and other specialists with expertise in irregular heartbeat.
Atrial fibrillation is only one of the arrhythmias treated at NewYork-Presbyterian. Comprehensive care is also available for ventricular tachycardia and fibrillation, Wolff-Parkinson-White syndrome, atrial flutter, and syncope.
At NewYork-Presbyterian, your arrhythmia diagnosis is personalized and accurate due to the latest electrophysiology testing, heart imaging techniques, and other exams. Personalized treatments include nonsurgical, implanted devices, and corrective surgery, with the best plan for each patient determined by you and your cardiac team at NewYork-Presbyterian.