Atrial Fibrillation

Atrial fibrillation (AF) is a condition with an irregular heart beat. It can be totally asymptomatic, which means that it can be difficult to detect. However, it is important to identify and treat it in order to prevent the formation of blood clots that may increase your risk of having a stroke.

A few facts about Atrial fibrillation:

  • AF is the most common sustained cardiac arrhythmia, occurring in 1–2% of the general population
  • Over 6 million Europeans suffer from this arrhythmia
  • It is estimated that the prevalence (frequency) of AF will at least double in the next 50 years, as the population ages
  • It increases with age, from 0.5% at 40–50 years, to 5–15% at 80 years
  • Men are more often affected than women
  • It is classified as a long-term heart condition.

How to identify atrial fibrillation

An irregular pulse should always raise the suspicion of AF, but an ECG recording at a hospital is necessary for a diagnosis of atrial fibrillation. Many episodes of AF terminate spontaneously within the first hours or days, however you should always have this checked by your GP.

What is the relationship between atrial fibrillation (AF) and stroke?

AF confers a 5-fold increased risk of stroke. One in five of all strokes are attributed to AF and yet it is often ‘silent’ in nature. In about one-third of patients with this arrhythmia, the patient is not aware of so-called ‘asymptomatic AF’.

AF can be associated with a variety of other long-term cardiovascular conditions. These medical conditions can have an additive effect on the perpetuation of AF: obesity; diabetes mellitus; chronic obstructive pulmonary disease (COPD).

AF is also associated with increased rates of heart failure and hospitalisation, a reduced quality of life and a reduced exercise capacity. It can cause symptoms such as palpitations (being aware of your heart beating fast), breathlessness, chest pain or fatigue.

How can you treat atrial fibrillation?

The immediate treatment of patients with AF is to prevent thrombo-embolic events, such as stroke and to improve or restore cardiac function. Warfarin treatment for AF reduces the likelihood of strokes by approximately 66%. An improvement in heart function can be achieved in most patients through immediate management of the heart rate. In a small number of patients the severity of AF-related symptoms and the compromised state, may require an immediate intervention or procedure to restore normal sinus rhythm.

Treatments for atrial fibrillation will depend on many different factors, including how long the condition has been present, whether there are any other medical conditions and whether you have been treated for it in the past.

There are a number of different interventions which can be used if the symptoms of the patient continue to be problematic. These include Electrical Cardioversion (DC shock) or ablation of the AF pathways by means of a catheter introduced into the groin.

Some good places to learn more about Atrial Fibrillation are Atrial Fibrillation Association and the British Heart Foundation websites.