Atrial Fibrillation – A Brief Overview

By
Sophie Robinson

Advanced Cardiac Physiologist
Cardiology Diagnostics
Sandwell and West Birmingham Hospitals
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It occurs when the top chambers of the heart (the atrium) start to twitch irregularly and rapidly. It is very common for people who have AF to be asymptomatic, however some experience symptoms such as:
Palpitations (fast heart rate)
Shortness of breath
Tiredness
Dizziness
Sometimes the cause of AF is not entirely known, but your risk of developing it increases with age. AF can also be caused by other heart conditions such as:
High blood pressure
Heart failure
Heart valve disease
The number of people being diagnosed with AF is increasing as a result of improved longevity and growth of the elderly population. Around 7% of people over the age of 65 will be affected by AF, with it being more common in males than females.
Because the atriums don’t contract properly and just ‘fibrillate’ this can result in blood becoming stagnant within the atrium which can lead to the development of blood clots. If a clot then travels to the brain, this may result in a stroke. However, if AF is detected and treated appropriately, your risk of stroke can be significantly reduced.
Various stroke risk stratification schemes have been developed in order to make the initial decision as to whether a patient with AF requires oral anticoagulation (blood thinner). Factors that result in a higher risk of stroke in those with AF, and therefore consideration of oral anticoagulation is recommended, include:
Heart failure
High blood pressure
Over 75 years old
Diabetes mellitus
Vascular disease
In addition to taking appropriate medication, healthy lifestyle changes will help reduce your risk of having a stroke. These lifestyle changes include:
Having a healthy diet
Regular exercise
Maintaining a healthy body weight
Do not smoke
Controlled blood pressure
Controlled cholesterol levels
Controlled blood sugar levels (if you have diabetes)
Some people can also experience AF intermittently, this is also referred to as paroxysmal AF, this means that sometimes the heart beat is normal and at other times it is irregular and in AF.
AF can be detected by feeling your pulse on your wrist. If you have AF, your pulse may feel irregular with some beats feeling stronger than others. The British Heart Foundation has a handy video to demonstrate how to do this, click here to view. If your GP suspects that you may have AF they may refer you for further investigations such as:
Electrocardiogram (ECG) – to take a snapshot of your heart’s current electrical activity
Holter ECG – a monitor which you take home and is worn for a period of time to record the electrical activity of your heart
Echocardiogram – to see how the muscles of your heart are beating and how well the valves are opening and closing.
As long as the right treatment is received, and a healthy lifestyle maintained, AF is a very manageable condition and you can carry on as you were before your diagnosis.
Websites with more information:

https://www.bhf.org.uk/informationsupport/conditions/atrial-fibrillation

https://www.nhs.uk/conditions/atrial-fibrillation/

https://www.bhf.org.uk/informationsupport/tests/checking-your-pulse

https://youtu.be/HogG6qy_3ug

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