Heart: Understanding Atrial Fibrillation Causes, Symptoms, and Management

Atrial fibrillation (AFib), the most common heart arrhythmia, affects millions globally. It's marked by an irregular, often rapid heartbeat and can lead to serious complications like stroke, heart failure, and other heart issues. Understanding its causes, recognizing symptoms, and knowing management options are vital for those living with AFib.

What is Atrial Fibrillation?

Atrial fibrillation (AFib) occurs when the heart's upper chambers (atria) beat irregularly and out of sync with the lower chambers (ventricles), disrupting normal blood flow. This increases the risk of blood clots forming in the atria, which can travel to the brain and cause a stroke. AFib can be intermittent, with episodes that come and go, or persistent, requiring treatment to restore a normal heart rhythm.

Causes of Atrial Fibrillation

AFib can result from a variety of factors, and often, multiple factors contribute to its development. Some of the most common causes include:

1. High Blood Pressure: Hypertension is one of the leading causes of AFib. High blood pressure forces the heart to work harder, which can lead to structural changes in the heart and the development of AFib.

2. Heart Disease: Conditions such as coronary artery disease, heart valve problems, and congenital heart defects can increase the risk of AFib. Scarring from a previous heart attack can also contribute.

3. Thyroid Disorders: Both an overactive thyroid (hyperthyroidism) and an underactive thyroid (hypothyroidism) can lead to AFib.

4. Age: The risk of AFib increases with age, particularly after the age of 60.

5. Lifestyle Factors: Obesity, excessive alcohol consumption, smoking, and high levels of stress can all contribute to the development of AFib.

6. Sleep Apnea: This condition is characterised by repeated interruptions in breathing during sleep, and is a significant risk factor for AFib.

7. Genetics: A family history of AFib increases the likelihood of developing the condition.

Symptoms of Atrial Fibrillation

AFib can present with a wide range of symptoms, varying from person to person. Some individuals may experience significant discomfort, while others might have no symptoms at all. The most common symptoms include:

Palpitations: A fluttering, pounding, or racing sensation in the chest is one of the hallmark signs of AFib.

Fatigue: Feeling unusually tired, even with minimal exertion, is a common symptom due to the heart's reduced efficiency.

Shortness of Breath: Difficulty breathing, especially during physical activity or when lying down, can be a symptom of AFib.

Dizziness or Lightheadedness: An irregular heartbeat can lead to reduced blood flow to the brain, causing dizziness or fainting spells.

Chest Pain: Some people with AFib may experience chest discomfort or pain, which should always be evaluated by a doctor to rule out a heart attack.

Weakness: Generalised weakness or a feeling of being unwell can also indicate AFib.

Management of Atrial Fibrillation

Managing Atrial Fibrillation (AFib) requires a multifaceted approach involving lifestyle changes, medications, and medical procedures to control the heart's rhythm and reduce stroke risk. Medications are central to AFib management, with rate control drugs like beta-blockers and calcium channel blockers used to slow the heart rate and ease symptoms. Antiarrhythmic medications may also be prescribed to maintain a normal heart rhythm, particularly in persistent AFib cases. To reduce stroke risk, blood-thinning medications (anticoagulants) are often recommended to prevent blood clots from forming in the atria.

Lifestyle modifications play a crucial role in managing AFib. A heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins supports heart health, while regular, doctor-approved exercise can improve cardiovascular fitness and lessen AFib symptoms. Maintaining a healthy weight is also important, as it can lower the likelihood of AFib episodes. Additionally, reducing alcohol and caffeine intake helps avoid potential AFib triggers, and stress management techniques such as yoga, meditation, and deep breathing can be effective in controlling stress, which is known to trigger AFib.

In some instances, medical procedures are necessary. Cardioversion, which uses electrical shocks or medications to reset the heart's rhythm, can be effective in certain cases. Catheter ablation, where a catheter is inserted to destroy small areas of heart tissue causing the abnormal rhythm, is another option. In more severe cases, a pacemaker might be implanted to help regulate the heart's rhythm.


When to Seek Medical Attention

If you experience symptoms of AFib, such as palpitations, chest pain, or shortness of breath, it's important to seek medical attention promptly. Early diagnosis and treatment can significantly reduce the risk of complications, including stroke and heart failure.

Conclusion

Atrial fibrillation is a serious condition that requires careful management, but with the right treatment and lifestyle changes, individuals with AFib can lead full, active lives. Understanding the causes, recognizing the symptoms, and following a comprehensive management plan are key to effectively controlling this common heart arrhythmia.

Content by: Dr. Aparna Jaswal, Director of Cardiology at Fortis Escorts Heart Institute & Research Centre, New Delhi

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