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Atrial Fibrillation

Originally published October 2009, updated August 2013


It’s not always love that makes
your heart beat faster!

atrial fibrillationRarely a day goes past without the media carrying some story or other about heart disease, heart attacks, preventative methods, new government initiatives to prevent heart disease, and so on. Problems with the heart are a very big risk indeed, especially as we grow older.

Many of us will have experienced a sudden moment when we can actually feel our heart pumping, often faster than we expected. At our age, it is not always caused by love! Much more likely it is atrial fibrilliation – a condition that causes an irregular, and often very fast, heart beat. Atrial fibrillation is surprisingly common and currently around 50,000 cases are being diagnosed in the UK every year. The risk increases with age – about one in 200 people aged between 50 and 60 have atrial fibrillation and this goes up to 1 in 10 people aged over 80.

Atrial fibrillation can be caused by abnormal electrical impulses in the heart. It can also be caused by complications from various diseases.

Irregular electrical pulses in the atria, the upper chambers of the heart, means that the atria no longer beat in an organized way and pump blood less efficiently through to the lower chambers of the heart, the ventricles. Although the heart will stop some of the irregular impulses from travelling down to the ventricles, they will still beat irregularly and often very rapidly, generating an abnormal heart beat. This irregular heartbeat may occur in short episodes lasting for minutes to weeks. It can even be permanent.

You will usually be aware you have atrial fibrillation as you can feel the heart pumping rapidly or feel it beating in an irregular way (heart palpitations). You may also suffer from dizziness, chest pains and often breathlessness. These symptoms are caused because when the heart beats too fast, it becomes less efficient. Small amounts of blood pumped faster by the heart are not as good as larger amounts that are pumped at the slower normal rate. This can lead to a pooling of blood in the veins of the lungs, and a reduced output of blood from the heart which can lead to these symptoms.

Some people with atrial fibrillation have no symptoms, particularly if their heart rate is not very fast, and sometimes the problem may then be diagnosed by chance when a doctor or nurse feels your pulse.

While the change in electrical impulses that can cause atrial fibrillation is most commonly due to high blood pressure – this puts a strain on the heart muscle – this is not always the case. Atrial fibrillation can also result as a complication from other heart problems; or can be triggered by an overactive thyroid gland, pneumonia; obesity; drinking a lot of alcohol or caffeine. In about one in nine cases, there is no apparent cause.

The main problem from atrial fibrillation is an increased risk of having a stroke. Atrial fibrillation causes turbulent blood flow in the heart chambers and this can lead to a small blood clot forming which can travel up to the brain. Other complications can include cardiomyopathy (weakening of the heart muscle) and increasing angina pains in people already suffering from angina.

There are various tests to confirm whether you have atrial fibrillation. The main one is an ECG (electrocardiogram) but can also include blood tests and an echocardiogram (ultrasound scan of the heart).

Today there are many ways to treat atrial fibrillation. A good source of information on the latest techniques is:

http://www.nhs.uk/Conditions/Atrial-fibrillation/Pages/Treatment.aspx



 

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