Atrial fibrillation, often shortened to AF or AFib, is one of the most common heart rhythm disorders seen in clinical practice. It occurs when the upper chambers of the heart, known as the atria, beat in an irregular and often rapid pattern, disrupting the normal electrical signals that coordinate the heartbeat.
Although many people have heard the term, atrial fibrillation can be difficult to recognise. Some individuals experience obvious symptoms, while others may have the condition for years before it is detected during routine medical testing. Understanding the signs and knowing when to seek medical advice can help reduce the risk of complications.
What Happens in Atrial Fibrillation?
In a healthy heart, electrical impulses travel in a predictable pattern, allowing the atria and ventricles to contract in a coordinated way. This rhythm ensures blood is pumped efficiently around the body.
In atrial fibrillation, these electrical signals become chaotic. Instead of contracting in an organised way, the atria quiver rapidly. This irregular activity may cause the heart to beat too fast or unpredictably, reducing its ability to pump blood effectively.
Over time, the condition may increase the risk of complications such as stroke, particularly if blood clots form in the atria and travel to the brain. For this reason, early diagnosis and appropriate management are important.
Common Symptoms
Atrial fibrillation can present differently from one person to another. Some patients notice clear symptoms, while others may feel relatively well.
Possible symptoms include:
- Heart palpitations or fluttering sensations in the chest
- Shortness of breath, particularly during exertion
- Fatigue or reduced exercise tolerance
- Dizziness or light-headedness
- Chest discomfort
However, some people experience no symptoms at all. In these cases, the condition may be detected incidentally during an ECG or other cardiac investigation.
What Causes Atrial Fibrillation?
Atrial fibrillation can develop for a variety of reasons. It is more common with increasing age and is often associated with other cardiovascular conditions.
Factors that may contribute include:
- High blood pressure
- Coronary artery disease
- Heart valve disease
- Sleep apnoea
- Thyroid disorders
- Excessive alcohol consumption
- Age-related changes in the heart
In some cases, no clear cause is identified. This is sometimes referred to as idiopathic atrial fibrillation.
How Is Atrial Fibrillation Diagnosed?
Diagnosis usually begins with a review of symptoms and a physical examination. A number of tests may be recommended to confirm the diagnosis and assess heart function.
Common investigations include:
- Electrocardiogram (ECG) to measure the heart’s electrical activity
- Holter monitoring, which records heart rhythm over 24 to 48 hours
- Echocardiography to evaluate heart structure and valve function
- Blood tests to identify contributing medical conditions
These investigations help determine the most appropriate treatment pathway.
Treatment Options
Management of atrial fibrillation is individualised. Treatment may focus on controlling heart rhythm, managing symptoms, or reducing the risk of complications such as stroke.
Possible treatment strategies include:
Lifestyle modifications
Reducing alcohol intake, improving sleep quality and managing cardiovascular risk factors may help control symptoms in some patients.
Medications
Certain medicines may help regulate heart rhythm or prevent blood clots.
Catheter ablation
This minimally invasive procedure targets small areas of heart tissue that trigger abnormal electrical signals.
Surgical treatment
In selected patients, surgical procedures may be considered to restore a more stable rhythm. These techniques aim to interrupt abnormal electrical pathways within the atria.
Mr Adrian Pick’s practice focuses on minimally invasive surgical approaches for selected patients with complex or persistent atrial fibrillation.
When to Seek Specialist Advice
If you experience persistent palpitations, unexplained fatigue or shortness of breath, it is important to speak with your GP. Early investigation may help identify atrial fibrillation before complications develop.
A referral to a cardiologist or cardiothoracic surgeon may be recommended when symptoms persist despite medical therapy, or when additional treatment options need to be considered.
A Personalised Approach to Heart Rhythm Care
Every patient’s experience with atrial fibrillation is different. Factors such as age, underlying heart conditions and previous treatments can influence the most appropriate management plan.
Careful assessment allows clinicians to recommend a treatment approach that aligns with the patient’s overall health, symptoms and lifestyle. For many people, appropriate management can significantly improve quality of life and reduce long-term risks.