Atrial fibrillation is a common abnormality of the rhythm of the heart. Find out more about AF and how it is treated.
What is atrial fibrillation (AF)?
Atrial fibrillation (AF) is a condition causing an irregular heartbeat due to abnormal and chaotic electrical activity within the heart. AF can also lead to the heart beating too fast or, less commonly, too slowly. AF can come and go or can be permanent. AF that comes and goes is known as “paroxysmal AF”
What symptoms does atrial fibrillation (AF) cause?
The most common symptom is a feeling that your heart is beating in an unusual way. People describe this as their heart racing, fluttering, quivering, thumping or having palpitations. Some people have no symptoms at all and some people only notice symptoms from time to time.
Other symptoms that can be caused by AF include:
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| Dizziness | Shortness of breath | Chest pain | Fatigue | Anxiety | Sweating |
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AF can have a significant effect on your mental health. It can be frightening and even lead to depression.
What causes atrial fibrillation (AF)?
It is not always known what causes AF, but there are a number of risk factors:
Risk factors:
- Age: AF can occur in adults of any age but is more common as you get older. 1 in 10 people over the age of 75 have AF.
- Weight: being overweight is the main reason for AF in almost 1 in 5 people. The more overweight people are, the greater the risk.
- Smoking: smoking increases the risk of AF and the more you smoke, the more the risk is increased.
- Heart Conditions: having other problems with the heart such as:
- high blood pressure
- coronary heart disease i.e. angina and heart attacks
- heart valve problems
- heart muscle problems.
Other medical conditions:
- Overactive thyroid
- Lung conditions
- Pneumonia
- Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
- Pulmonary Embolus
- Lung Cancer
- Type 2 Diabetes
Triggers
Although the risk factors for AF are well known, it is often not clear what actually starts AF. However, there are some things that can definitely set it off:
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Too much alcohol intake, especially binge drinking |
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Too much caffeine: coffee, energy drinks or tea |
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Illegal drugs, especially amphetamines and cocaine |
Alcohol
Drinking more than the recommended amount of alcohol is known to cause AF. This is even worse for “binge drinking”; drinking large amounts over a short period of time.
Alcohol can also damage heart muscle and contribute to narrowing of blood vessels by causing high blood pressure. Although there is a feeling that a small amount of alcohol is beneficial, the evidence for this is not clear. If you do choose to drink alcohol the guidelines are:
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Smoking
Smoking has long and short term effects:
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Short term - Nicotine in cigarettes is a stimulant:
Long term - smoking narrows the blood vessels that take blood to the heart:
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How is atrial fibrillation (AF) diagnosed?
The first clue that you may have AF would be if you or your doctor noticed that your pulse is irregular. Normally, your heart will beat steadily at 60 to 100 beats per minute. If you have AF, the heart will not beat in a regular pattern. It might also feel like sometimes your heart is beating harder, whilst at other times it is beating softer.
If you have an irregular pulse, you will then have an electrical recording of your heart called an “ECG”. An ECG is the only way to be sure of a diagnosis of AF.
If you do have AF on the ECG, your doctor will then organise some tests to look for the risk factors for AF such as:
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Echocardiogram |
a heart scan to look for any problems with the structure of the heart and heart valves. An echocardiogram is similar to the ultrasound scan that pregnant women have |
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Chest X-ray |
to look for any lung conditions that might be an alternative cause of your symptoms |
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Blood tests |
to look for associated medical conditions |
What problems does atrial fibrillation (AF) cause?
Strokes and Mini-strokes
AF increases the risk that blood clots form within the heart. These clots can then travel around the body and block blood vessels. The most common place the blood clots go are to the brain causing strokes (also known as cerebrovascular events or “CVE”s) or mini-strokes (also known as transient ischaemic attacks or “TIA”s).
Heart failure
Having a fast heart rate due to AF for long periods of time can affect how well the heart pumps. A reduction in the strength of heart pumping is called heart failure.
Coping with a diagnosis of AF
To start with, having a fast or irregular heartbeat can be scary. It is common for people to feel very anxious. In the longer term, coming to terms with AF can be hard. This is normal but, in some people, having AF can lead to depression.
If you are noticing that you are feeling anxious or down, it is important and always helpful to speak to someone about this. Unless you tell them, your friends and family may not realise the impact that this has had.
Your GP is another good person to turn to. They will be aware of the potential effect a diagnosis of AF can have and will be able to support you. In addition, they may be able to direct you to other sources of help such as counselling or other types of psychological support.
Eating healthily, having a healthy weight and doing physical activity will improve your general health and often makes people feel better in themselves. Mindfulness, relaxation, meditation and yoga have all helped people struggling with atrial fibrillation.
