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by Debra Wood, RN
Atrial fibrillation is an irregular and often fast beating of the upper part of the heart. The main job of the upper part of the heart is to push blood into the lower part of the heart. The lower part of the heart then pushes blood out to the body. Atrial fibrillation can decrease the amount of blood that reaches the lower chambers and then the body. Blood can also pool in the upper heart. This increases the risk of blood clots and stroke. Atrial fibrillation may be:
The beating of the heart is started and controlled by electrical signals. Normally these signals start from an area of the heart called the SA node. The signals move from the SA node through the heart in an organized way. The top part of the heart should beat first, then the lower chambers. Any problem in this system can cause atrial fibrillation. Problems may include:
Sometimes the cause is not known.
Risk Factors TOP
Atrial fibrillation is more common in men. It also happens more often in people aged 55 years and older. Other factors that may increase your chance of atrial fibrillation include:
Certain habits and food or drink choices can stimulate the heart. They can increase the risk of atrial fibrillation:
Atrial fibrillation may not cause any symptoms. Symptoms that do occur may range from mild to severe.
Fast beating in the upper part of the heart may cause:
If the atrial fibrillation is decreasing the amount of blood that is being pumped out to the body you may have:
The doctor will ask about your symptoms and medical history. A physical exam will be done to look for any signs of heart disease. The doctor may suspect a problem after listening to the heart and taking a pulse. To see the electrical activity of the heart, the doctor may do one or more of the following:
The goal of treatment will depend on the cause of the atrial fibrillation and how much it affects your life. When possible, the fibrillation will be stopped.
Some atrial fibrillation keeps coming back or is permanent. This type may need treatment to reduce the risk of other related problems.
Heart Rhythm Control
Steps that may help slow or stop atrial fibrillation include:
Clot and Stroke Prevention
If the atrial fibrillation continues, medicine may be needed to decrease the chance of blood clots. Atrial fibrillation allows blood to pool in the upper part of the heart. Blood clots can form in this pool, travel out of the heart, and cause a stroke. Medicine will help to stop these clots from forming. However, it can also increase the risk of severe bleeding. Most anti-clotting medicine will need close watching by care team.
A procedure called left atrial appendage closure (LAAC) may be considered if medicine is not an option. This procedure seals off a small area of the upper heart where clots tend to form.
Reducing Triggers TOP
Certain habits can trigger an episode of atrial fibrillation or make it worse. To decrease the chance of making the atrial fibrillation worse:
It is not always possible to prevent atrial fibrillation.
American Heart Association
Heart Rhythm Society
Canadian Heart Rhythm Society
Heart and Stroke Foundation of Canada
Atrial fibrillation. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115288/Atrial-fibrillation. Updated July 31, 2017. Accessed November 28, 2017.
Atrial fibrillation. CardioSmart website. Available at: https://www.cardiosmart.org/Heart-Conditions/Atrial-Fibrillation. Accessed November 28, 2017.
Electrical cardioversion. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/electrical-cardioversion. Accessed November 28, 2017.
Explore atrial fibrillation. National Heart,Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/af. Updated July 1, 2011. Accessed November 28, 2017.
Left atrial appendage and closure. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/left-atrial-appendage-closure. Updated June 2016. Accessed July 14, 2016.
12/13/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115288/Atrial-fibrillation: Lubitz SA, Yin X, Fontes JD, et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA. 2010;304(20):2263-2269.
5/11/2012 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115288/Atrial-fibrillation: Osbak PS, Mourier M, Kjaer A, Henriksen JH, Kofoed KF, Jensen GB. A randomized study of the effects of exercise training on patients with atrial fibrillation. Am Heart J. 2011;162(6):1080-1087.
1/2/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115288/Atrial-fibrillation: Abed HS, Wittert GA, Leong DP, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: A randomized clinical trial. JAMA. 2013;310(19):2050-2060.
7/1/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115288/Atrial-fibrillation: Qureshi WT, O'Neal WT, Khodneva Y, et al. Association between opioid use and atrial fibrillation: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. JAMA Intern Med. 2015;175(6):1058-1060.
Last reviewed November 2017 by EBSCO Medical Review Board Michael J. Fucci, DO, FACC
Last Updated: 2/2/2018
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