Atrial fibrillation (AF or afib) is a cardiac arrhythmia (abnormal heart rhythm) that involves the two upper chambers (atria) of the heart. It can often be identified by taking a pulse and observing that the heart beats don't occur at regular intervals, but a conclusive indication of AF is the absence of P waves on an electrocardiogram (ECG). AF is the most common arrhythmia; risk increases with age, with 8% of people over 80 having AF.

Symptoms of Atrial Fibrillation

A heart in atrial fibrillation doesn't beat efficiently. It may not be able to pump an adequate amount of blood out to your body with each heartbeat, causing a drop in your blood pressure.

Palpitations, which are sensations of a racing, uncomfortable, irregular heartbeat or a flopping in your chest

Heart valve disease: This can be something you are born with or be caused by infection or degeneration/calcification of valves with age.

Enlargement of the left ventricle walls (left ventricular hypertrophy)

What Causes Atrial Fibrillation?

Atrial fibrillation is associated with many conditions, including:

High blood pressure

Coronary artery disease (hardening of the heart arteries)

Heart valve disease

Having undergone heart surgery

The two lower chambers - the right and left ventricles - of the heart are also affected by AF. Rapid and irregular beating does not allow sufficient time for the ventricles to adequately fill with blood before being stimulated to pump the blood out of the heart again.

Heart palpitations (described as "pounding", "racing" or "fluttering" heart)

Shortness of breath

How is atrial fibrillation treated?
The treatment for atrial fibrillation depends on how severe your symptoms are. It also depends on whether you have heart disease or have recently had a stroke.

To prevent the possibility of clotting and stroke, doctors often prescribe the drug warfarin to thin the blood in AF patients determined to have a high risk of stroke. Individuals on warfarin therapy must be monitored with periodic blood tests to make sure their blood is thin enough to prevent clots, but not so thin as to promote bleeding.

Long-term treatment varies depending on the cause of the atrial fibrillation or flutter. Medication may include beta-blockers, calcium channel blockers, digitalis or other medications (such as anti-arrhythmic drugs), which slow the heartbeat or the conduction of the impulse from the atria to the ventricles.

Radiofrequency ablation may be effective in some patients when medications don't work. In this procedure, thin and flexible tubes are introduced through a blood vessel and directed to the heart muscle. Then a burst of radiofrequency energy is delivered to destroy tissue that triggers abnormal electrical signals or to block abnormal electrical pathways.

Digoxin (Lanoxin®) is often used to treat patients with heart failure, since it can stimulate the left ventricle to contract and pump blood a little more vigorously. Digoxin also slows electrical conduction through the AV node and can thus decrease the rate at which electrical impulses are conducted from the atria to the ventricles.

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