Atrial Fibrillation

12 January 2025

An irregular and often fast heart rhythm can feel frightening and a cause for concern. Find out about other symptoms, causes and how you can manage the condition and improve your quality of life.

What is Atrial Fibrillation?

Atrial fibrillation (AF), also known as AF, is an irregular and often abnormally fast heart rhythm that disrupts the normal pumping function of the heart.

In a healthy heart, the upper chambers (atria) contract in a coordinated way, sending electrical signals to the lower chambers (ventricles) to pump blood throughout the body.

In AF, these electrical signals become chaotic, causing the atria to quiver instead of contract effectively.

This disrupts the normal flow of blood and can lead to several complications, including stroke, heart failure, and even dementia.

Causes

Several factors can contribute to atrial fibrillation, including:

High blood pressure: Uncontrolled high blood pressure is a major risk factor for AF. Chronically high blood pressure puts stress on the heart, which can damage heart tissue and disrupt electrical signals.
Coronary artery disease: Narrowing of the arteries that supply blood to the heart muscle (coronary arteries) can damage heart tissue and increase the risk of AF.
Heart valve disease: Abnormal heart valves, particularly affecting the mitral or aortic valves, can disrupt blood flow and contribute to AF.
Overactive thyroid: An overactive thyroid gland can increase your heart rate and contribute to AF.
Sleep apnoea: Obstructive sleep apnoea, a condition where breathing repeatedly stops and starts during sleep, can increase the risk of AF. This is because the oxygen deprivation and strain on the body during sleep apnoea episodes can put stress on the heart.
Certain medications: Some medications, such as decongestants and stimulants, can trigger AF episodes, especially in individuals with underlying risk factors.
Excessive alcohol consumption: Heavy alcohol consumption can damage heart tissue and disrupt electrical signals, increasing the risk of AF.
Obesity: Being overweight or obese is a risk factor for AF. Excess weight puts a strain on the heart and can contribute to other conditions like high blood pressure and sleep apnoea, which further elevate AF risk.
Age: The risk of AF increases significantly with age. As we age, the heart’s structure and electrical system can weaken, making it more susceptible to AF.
Family history: Having a close relative with AF increases your risk. This suggests a potential genetic component to the condition in some cases.

Who is At Risk for Atrial Fibrillation?

Anyone can develop atrial fibrillation, but certain factors increase your risk:

People with the conditions mentioned above: High blood pressure, coronary artery disease, heart valve disease, overactive thyroid, sleep apnoea, etc.
People with a lifestyle that contributes to these conditions: Those with a poor diet, physically inactive lifestyle, or smokers.
Older adults: The risk of AF increases significantly with age, especially after 65.
Individuals with a family history of AF.

Symptoms

The symptoms of AF can vary from person to person. Some people may experience no symptoms at all, while others may have one or more of the following:

Palpitations: A fluttering or racing sensation in the chest. This is a common symptom of AF and can feel quite alarming.
Irregular heartbeat: You may notice your pulse feels irregular or rapid. This is a hallmark sign of AF and can be detected by taking your pulse at your wrist or neck.
Shortness of breath: This can occur because the heart is not pumping blood efficiently due to the irregular rhythm.
Fatigue: You may feel unusually tired or low on energy, even after getting enough sleep. This can be caused by decreased blood flow throughout the body.
Lightheadedness or dizziness: This can occur due to decreased blood flow to the brain, especially during episodes of rapid heart rate.
Chest pain: While less common, some people with AF experience chest pain, which can be a frightening symptom and necessitates immediate medical attention.

Diagnosing Atrial Fibrillation

One of our GPs will be able to provide an accurate diagnosis based on a combination of methods. These usually involve the following:

Medical history and physical exam: Our GP will ask about your symptoms, medical history, and risk factors for AF. They will also listen to your heart for any irregular heartbeats using a stethoscope.
Electrocardiogram (ECG): This test measures the electrical activity of your heart and can help detect AF episodes. An ECG is a painless test that involves attaching electrodes to your chest, arms, and legs to record your heart’s electrical signals.
Holter monitor: This portable ECG device is worn for 24-48 hours to record your heart rhythm throughout the day and night. This can be helpful in capturing intermittent AF episodes that may not be present during a standard ECG.
Echocardiogram: This ultrasound imaging test uses sound waves to create an image of your heart, allowing your doctor to assess the structure and function of your heart chambers and valves. An echocardiogram can help identify any underlying heart abnormalities that may be contributing to AF.
Blood tests: In some cases blood tests may be ordered to check for thyroid problems, electrolyte imbalances, or other underlying conditions that could be mimicking AF symptoms.

Taking Control of Your Heart Health

While there’s no cure for AF, there are effective strategies to manage the condition, prevent complications, and improve your quality of life. Here’s a look at some key approaches:

Blood pressure control: Maintaining healthy blood pressure is crucial for reducing the risk of AF complications such as stroke. Medications and lifestyle modifications may be necessary to achieve optimal blood pressure control. This may involve incorporating dietary changes like reducing salt intake, engaging in regular exercise, and managing stress effectively.
Rate control medications: These medications help regulate your heart rate and prevent it from becoming too fast, especially during AF episodes. Beta-blockers and calcium channel blockers are common types of rate control medications used for AF.
Rhythm control medications: In some cases, medications may be used to try to restore a normal heart rhythm. Antiarrhythmic medications work by targeting the electrical signals in the heart to try to get them back into a coordinated rhythm. However, these medications may not be suitable for everyone and can have side effects.
Catheter ablation: This minimally invasive procedure uses radiofrequency energy to target and destroy small areas of heart tissue that are causing the abnormal electrical signals. This can be an effective option for certain individuals with AF, especially those with focal triggers for their arrhythmia.
Anticoagulation therapy: If you have an increased risk of blood clots due to AF, your doctor may prescribe blood-thinning medications (anticoagulants) to help prevent strokes. These medications work by reducing the ability of your blood to form clots. Blood thinners come with an increased risk of bleeding, so careful monitoring and evaluation are necessary to determine if the benefits outweigh the risks for you.

Additional Management Strategies

Regular doctor visits: Schedule regular appointments with your GP to monitor your AF, assess the effectiveness of your treatment plan, and make adjustments as needed. Early detection and management of any changes in your AF or overall health is crucial.
AF education: The more you know about AF, the better equipped you’ll be to manage your condition. Talk to your doctor and seek reliable educational resources from organizations like the American Heart Association or the National Heart, Lung, and Blood Institute to understand AF, treatment options, and potential complications.
Support groups: Connecting with others who understand the challenges of AF can be a source of encouragement, information, and shared experiences. Support groups can provide a safe space to discuss your concerns, learn coping mechanisms from others, and feel less alone in managing your condition.

Arranging To Visit A Private GP

If you have any concerns about your heart make an appointment with one of our private GPs. Appointments are available to everyone and can often be booked for the same day. There is no need to be registered with our Buckinghamshire hospital, or live locally.

Should you have insurance which covers a GP visit, we can in most cases invoice. Where you are paying directly, the cost for a 30 minute consultation is £125.

Any additional costs will always be discussed. They could apply if you are referred for an MRI scan, or to a consultant, or for other agreed decisions to support your health.

Meet Our Resident Private GP

Dr Chamali is welcoming and highly experienced. He offers his patients sound diagnosis and treatment, along with individual care focused on their future health.