Overview
Atrial fibrillation (or simply AF) is a type of heart rhythm problem where your heartbeat is not steady. See a GP if you think you may have it.
Symptoms
The main symptoms of atrial fibrillation are:
- An irregular heartbeat
- A sudden feeling of your heart pounding, racing, fluttering, skipping or missing a beat (heart palpitations) – this may last for a few seconds up to a few minutes
- A heart rate faster than 100 beats per minute
- Fatigue
- Reduced exercise capacity
- Chest pain or tightness
- Breathlessness
- Light-headedness
Sometimes there are no symptoms, and atrial fibrillation is found as part of a routine check-up or when you're having tests for something else.
If you do get symptoms, they may start and stop on their own (paroxysmal atrial fibrillation) or stop after treatment (persistent atrial fibrillation).
Over time, you may always have symptoms (permanent atrial fibrillation).
AF can lead to blood clots forming in the top chambers of the heart and is therefore associated with the risk of stroke.
Causes
Atrial fibrillation is caused by a problem with the electrical system that makes your heart beat. Signals in the top chambers of your heart become disorganised causing the bottom chambers to beat in a poorly controlled, irregular manner.
Anyone can get it, but you may be more likely to get it if you are:
- Older than 55 years
- Male
- Obese or overweight
- A smoker
- Participating in endurance sports (for example, long‑distance running or rowing)
Atrial fibrillation can also be caused by another condition such as:
- High blood pressure
- Heart conditions like heart failure, mitral valve disease or Wolff‑Parkinson‑White syndrome
- Heart attack
- Chronic kidney disease
- Overactive thyroid (hyperthyroidism)
- Diabetes
- Sleep apnoea
Diagnosis
If atrial fibrillation is suspected, then confirmation is needed on an ECG. If AF is paroxysmal then a longer period of ECG monitoring may be required.
You will also have tests to see if anything else could be causing your symptoms and to check your heart rhythm and rate during AF. Tests may include:
- Ambulatory ECG
- Echocardiogram (echo)
- Blood tests
Treatment
If you have been diagnosed with atrial fibrillation, you will have regular check-ups to make sure your symptoms are under control.
You may be given medicine to:
- Control the heart rate
- Control the rhythm
- Reduce the risk of blood clots and strokes (anti‑coagulants)
Other possible treatments for atrial fibrillation include:
- Direct current cardioversion
- Pulmonary vein isolation (ablation to block extra electrical signals that trigger AF)
- Pacemaker and AV node ablation
Sometimes atrial fibrillation can be caused by another health condition or medicine. In these cases, treating the condition or stopping the medicine can improve the symptoms.