antiarrhythmics

What is atrial fibrillation (AFib)?

Atrial fibrillation, also known as AFib or AF, is one of the most common types of arrhythmias. Arrhythmias are problems with the rate or rhythm of your heartbeat. They can cause your heart to beat too slowly, too fast, or in an irregular way.

If you have AFib, your heart beats irregularly and sometimes much faster than normal. Also, your heart's upper and lower chambers do not work together as they should. When this happens, the lower chambers do not fill completely or pump enough blood to your lungs and body. This can cause symptoms such as dizziness, fatigue, and a pounding heartbeat.

AFib may happen in brief episodes, or it may be a permanent condition. It's very important to treat it, since AFib can put you at risk for stroke and other heart conditions.

What causes atrial fibrillation (AFib)?

AFib is most often caused by changes to the heart's tissue or the electrical signaling that helps the heartbeat. These changes can happen due to different conditions and factors, such as high blood pressure, coronary artery disease, congenital heart defects, infections, and aging. Sometimes the cause is unknown.

Who is more likely to develop atrial fibrillation (AFib)?

Anyone can develop AFib, but there are certain things that raise your risk for it:

• Aging. The risk of atrial fibrillation increases as you get older, especially when you are over age 65.
• Family history and genetics. AFib can run in families. So can heart disease, which raises your risk of AFib.
• Some lifestyle choices. Your risk is higher if you drink a lot of alcohol, use certain illegal drugs such as cocaine and methamphetamines, or smoke.
• Having certain health conditions, such as:
  • High blood pressure
  • Diabetes
  • Heart failure
  • Heart valve diseases
  • Obesity
  • Hyperthyroidism
  • Chronic kidney disease
  • COPD and other lung diseases
  • Sleep apnea
• Race. AFib is more common in people with European ancestry.
• Recent surgery. You may be at risk of atrial fibrillation in the early days and weeks after surgery on your heart, lungs, or esophagus.

What are the symptoms of atrial fibrillation (AFib)?

Some people who have AFib don't have any symptoms and don't know they have it. If you do have symptoms, you may only notice them once in a while. Or you may have symptoms that are more frequent. And in some cases, the symptoms might be severe. If you have heart disease, you are more likely to notice your symptoms. And those symptoms could get worse if your heart disease gets worse.

The symptoms of AFib can include:

• Extreme fatigue, which is the most common symptom
• Heart palpitations (the feeling that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast)
• Trouble breathing, especially when lying down or when exercising
• Chest pain
• Dizziness or fainting
• Low blood pressure

What other problems can AFib cause?

If AFib is not treated, it can lead to serious health problems (complications) such as:

• Stroke
• Heart failure
• Blood clots
• Sudden cardiac arrest (SCA)
• Cognitive impairment and dementia

To help prevent these problems, it's important to contact your health care provider if you are having symptoms. If you do have AFib, the sooner you are diagnosed and treated, the better.

How is atrial fibrillation (AFib) diagnosed?

To find out if you have AFib, your provider:

• Will ask about your medical history, including your symptoms, lifestyle, and any other health conditions you may have
• Will ask about your family history, to find out if you have relatives who have or had AFib
• Will do a physical exam
• May order blood tests
• Will likely order heart tests, such as an electrocardiogram (also called an EKG or ECG) and echocardiogram
• May ask you to wear a heart monitor device that records your heart's electrical activity

What are the treatments for atrial fibrillation (AFib)?

The treatments for AFib may include:

• Blood thinner medicines that help prevent blood clots from forming.
• Medicines to control your heart's rhythm and rate.
• Following heart-healthy lifestyle changes, such as:
  • Following a heart-healthy eating plan that limits saturated fats, salt, and cholesterol. An example is the DASH eating plan.
  • Limiting or avoiding alcohol, because it can increase your heart rate.
  • Aiming for a healthy weight.
  • Getting regular physical activity.
  • Managing stress.
  • Quitting smoking.
• Procedures such as:
  • Electrical cardioversion, which restores your heart rhythm using low-energy shocks to your heart.
  • Catheter ablation, which scars the tissue that is causing the arrhythmia. The scar tissue blocks the abnormal heart signals.
• Surgeries such as:
  • Surgery to put in a pacemaker to help control the arrhythmia.
  • A Maze procedure, which creates scar tissue in a maze-like pattern in certain parts of the heart.
  • Left atrial appendage closure, a surgery on a small sac in the muscle wall of your left atrium (the upper left chamber of your heart). It helps prevent blood clots and can reduce your risk of stroke. This surgery is for people who are not able to take blood thinners.

Can atrial fibrillation (AFib) be prevented?

There are steps you can take to help lower your risk of atrial fibrillation, such as:

• Making heart-healthy lifestyle changes:
  • Following a heart-healthy eating plan
  • Limiting or avoiding alcohol
  • Aiming for a healthy weight
  • Getting regular physical activity
  • Managing stress
  • Not smoking
• Avoiding illegal drugs, such as cocaine and methamphetamines
• Taking antiarrhythmic medicine (medicine to treat arrhythmia) if you are having heart surgery
• Treating any health conditions that could raise your risk of AFib

NIH: National Heart, Lung, and Blood Institute

What is an arrhythmia?

An arrhythmia is a problem with the rate or rhythm of your heartbeat. Your heart beats too quickly, too slowly, or with an irregular pattern. Changes in the electrical signals that control your heartbeat cause arrhythmias.

• When your heart beats faster than normal, it's called tachycardia.
• When your heart beats too slowly, it's called bradycardia.
• When the signal to beat comes too early, it's called a premature or extra heartbeat. It may feel like your heart skipped a beat.

There are many types of arrhythmias. Arrhythmias may affect the upper or lower chamber of your heart. The most common type of arrhythmia is atrial fibrillation, which causes an irregular and fast heartbeat.

Some arrhythmias are harmless, such as when your heart rate speeds up during exercise and slows down when you sleep. But if you have a frequent irregular rhythm, it may mean your heart isn't pumping enough blood into your body. Getting treatment and following a heart-healthy lifestyle can help control arrhythmias. It may also help prevent heart damage that can trigger some heart arrhythmias.

What causes an arrhythmia?

Many factors can affect your heart's rhythm, such as having had a heart attack, smoking, congenital heart defects, and stress. Other factors that could increase your risk for some types of arrhythmias could include if you:

• Have a family history of arrhythmias.
• Have certain health conditions, which can include heart and blood vessel diseases, lung diseases, kidney diseases, obesity, and sleep apnea.
• Are an older adult.
• Have had recent surgery for your heart, lungs, or throat.
• Take certain medicines for other health conditions.
• Use illegal drugs.

If you have risk factors, some situations that make your heart work harder, raise your blood pressure, or cause strong emotional stress may trigger an arrhythmia.

What are the symptoms of an arrhythmia?

You may not have any noticeable symptoms of an arrhythmia. Your provider may find an arrhythmia during your routine checkup. Symptoms of an arrhythmia can include:

• Fast or slow heartbeat
• Skipping, fluttering, or pounding heartbeats
• Chest pain or discomfort
• Dizziness or fainting
• Shortness of breath
• Sweating
• Tiredness or weakness

Seek emergency medical care if you have chest pain, shortness of breath, or think you are having a heart attack.

How is an arrhythmia diagnosed?

To find out if you have an arrhythmia, your health care provider may order an electrocardiogram (EKG). This test records your heart's electrical activity and is the most common for finding an arrhythmia. Your provider may also:

• Ask about your medical history, including your symptoms and lifestyle habits.
• Do a physical exam, which includes checking your heartbeat and pulse.
• Order blood tests and other heart tests.
• Check your legs or feet for swelling.
• Look for signs of other health conditions that could cause an arrythmia, such as thyroid disease.

What are the treatments for an arrhythmia?

Treatment may include medicines, an implantable cardioverter-defibrillator (ICD) or pacemaker, or sometimes surgery. Your provider may also recommend avoiding activities that may trigger your arrhythmia.

The goal of treatment is to restore a normal heart rhythm. If not treated, arrhythmias can damage your heart, brain, and other organs and could be life-threatening.

Can arrhythmias be prevented?

To help prevent an arrhythmia, your provider may suggest that you make heart-healthy lifestyle changes and treat health conditions that may cause arrhythmias.

NIH: National Heart, Lung, and Blood Institute