Atrial fibrillation

Atrial fibrillation (AF) is a common irregular heart rhythm, which doctors also call an arrhythmia.

In atrial fibrillation, the top chambers of your heart (the atria) can quiver or twitch. The medical word for this is fibrillate. It makes your heart beat in an irregular way.

Atrial fibrillation is not usually life threatening in itself, and many people with it live normal, healthy lives. But in some cases, treatment will be needed or recommended.

For some people, atrial fibrillation can cause blood clots to form in the heart, and these clots may lead to a stroke. How likely this is depends on other things about you, including:

• age (being older)
• whether you have high blood pressure
• heart failure
• diabetes
• a previous history of blood clots

Changes to your lifestyle and treatment can lower this risk.

Some people with atrial fibrillation have no symptoms at all. Many aren't even aware that their heartbeat is irregular. Sometimes the problem only turns up during routine tests, or when doctors are looking into another condition.

The most obvious symptom of atrial fibrillation is palpitations, which simply means being aware of your own heartbeat. Your heart might feel like it's pounding, fluttering or beating irregularly. You may notice these sensations in your chest, throat or neck.

You may also feel that your heart is beating fast, even when you're not exercising.

You may also have:

• tiredness
• breathlessness
• dizziness
• feeling faint
• chest discomfort or pain

You or someone else has heart palpitations and:

• dizziness
• sudden shortness of breath
• chest pain
• loses consciousness

Atrial fibrillation can come in different forms:

• intermittent (paroxysmal), which lasts for a few minutes or hours
• persistent, where an episode lasts for more than 7 days
• long-term persistent, which is continuous and can last over a year
• permanent, which does not go away

Atrial fibrillation can come and go, and an episode may last anywhere from a few minutes to a few hours. When it happens like this, it's called paroxysmal atrial fibrillation. Because the problem isn't there all the time, paroxysmal atrial fibrillation can be hard to detect.

A portable or ambulatory electrocardiogram (ECG) recorder can help your doctor diagnose it. The device records your heart rate for 24 hours or longer, so it has a better chance of catching an episode when one occurs.

In some cases, atrial fibrillation can be picked up by a simple check, such as:

• a pulse check
• a single lead ECG device, for example a single sensor attached to the chest or one built into a watch strap

If your doctor thinks you may have atrial fibrillation, you may be sent for other tests. These can include:

• a 12 lead ECG, which gives a more detailed recording of the heart rhythm from 12 sensors attached to the chest
• an echocardiogram

You may not need treatment if your doctor has assessed your health and your heart rate returns to normal. Your doctor will decide whether any treatment would help you.

Anticoagulant medicines stop harmful blood clots from forming. People often call them blood thinners, but they don't really thin the blood. What they do is make your blood take longer to form a clot.

If you have atrial fibrillation and you're at risk of a stroke, your doctor may prescribe an anticoagulant. The aim is to lower the chance of clots forming inside the heart, because these clots can raise the risk of stroke.

Other treatments for atrial fibrillation focus on controlling the rate and rhythm of the heart. They include:

• medicine, like beta blockers and anti-arrhythmic drugs
• ablation
• having a pacemaker fitted
• cardioversion

The treatment you need for atrial fibrillation depends on:

• the type of atrial fibrillation
• symptoms
• any underlying cause like an overactive thyroid
• age
• overall health