Atrial fibrillation (AF or A-Fib) is a common heart rhythm disorder, especially among the elderly. According to the American Heart Association (AHA), about 2.5 million people in the United States suffer from atrial fibrillation, and this number has a tendency to rise year by year as the population ages.
The symptoms of atrial fibrillation vary from person to person. Some patients may not have any symptoms, or even be discovered during a physical examination. Other patients will have obvious symptoms, which are usually related to abnormal heart function. Knowing the symptoms of atrial fibrillation can help early identification and take appropriate treatment measures.
Palpitations are one of the most common symptoms. Patients will feel that their heartbeats have become irregular, beat fast, or feel abnormal when beating. Many people describe this palpitation as "fast heartbeat" or "irregular beating". This symptom usually worsens after activity and may occasionally occur when resting.
Because the atria cannot contract effectively, the heart cannot effectively pump blood to various parts of the body, and patients may feel unusually tired and weak. This is because the various tissues and organs in the body are not getting enough oxygen and nutrients, especially when doing daily activities, the fatigue is more obvious.
Atrial fibrillation may affect the heart's pumping efficiency, resulting in poor blood flow, especially during exercise or more physical activity, and patients may feel shortness of breath or difficulty breathing. This symptom is more common in patients with more severe atrial fibrillation.
Some patients with atrial fibrillation may experience chest discomfort or chest pain. Although chest pain can also be a symptom of other heart diseases (such as angina or myocardial infarction), in patients with atrial fibrillation, chest pain or pressure may be caused by the poor pumping function of the heart.
Atrial fibrillation may cause poor blood circulation, which can affect blood supply to the brain, leading to dizziness, vertigo, and even fainting. In some cases, patients may suddenly feel dizzy when standing up, which is also a common symptom of atrial fibrillation.
Because the heart's pumping function is affected, patients with atrial fibrillation usually feel an increased burden on the heart when exercising or doing physical activities, and their exercise tolerance is significantly reduced. Even with light activities, they may feel shortness of breath, fatigue, or discomfort.
Atrial fibrillation is not a single disease, it is usually caused by multiple factors. The following are common causes and risk factors for atrial fibrillation:
Hypertension is one of the most common causes of atrial fibrillation. Long-term high blood pressure increases the burden on the heart, leading to changes in heart structure, especially dilation and dysfunction of the atria. Such changes increase the risk of atrial fibrillation.
Coronary heart disease, myocardial infarction and other heart diseases are also closely related to atrial fibrillation. Insufficient blood supply to the heart or damage to heart tissue will affect the normal electrical activity of the heart, which will lead to atrial fibrillation.
Problems with heart valves, such as mitral stenosis or mitral valve prolapse, often lead to poor blood flow, which can cause atrial fibrillation. Valvular disease may make the atria more fragile and dilated, increasing the risk of atrial fibrillation.
Hyperthyroidism is an important factor in causing atrial fibrillation. Hyperthyroidism can lead to excessive metabolism, increase the burden on the heart, and cause atrial fibrillation.
Long-term excessive drinking (especially alcoholism) and excessive caffeine intake (such as excessive coffee or energy drinks) may stimulate the heart and cause arrhythmia. Heavy drinking is even called "Holiday Atrial Fibrillation" (Holiday Heart Syndrome), because excessive drinking during holidays can induce atrial fibrillation.
Certain chronic lung diseases, such as chronic obstructive pulmonary disease (COPD) and pulmonary embolism, can also increase the risk of atrial fibrillation. Lung disease may lead to insufficient oxygen supply, affect the electrical activity of the heart, and cause atrial fibrillation.
Studies have shown that atrial fibrillation has a certain genetic tendency. Individuals with relatives suffering from atrial fibrillation in their families have a relatively higher risk of developing the disease.
The incidence of atrial fibrillation gradually increases with age. The incidence of atrial fibrillation is higher in the elderly population over 65 years old. This is closely related to the natural aging process of the heart structure, vascular hardening and other health problems.
Obesity and lack of exercise are independent risk factors for atrial fibrillation. Excessive weight increases the burden on the heart, and obesity can also lead to high blood pressure, diabetes and other diseases, all of which increase the risk of atrial fibrillation.
The diagnosis of atrial fibrillation usually depends on the patient's symptoms, physical examination and some auxiliary examinations. Early diagnosis is crucial for treatment.
The doctor will first ask the patient about symptoms, such as palpitations, chest pain, fatigue, etc., as well as the frequency and duration of these symptoms. The physical examination includes auscultation of heart sounds, especially checking for irregular heartbeats, which are typical signs of atrial fibrillation.
The electrocardiogram is the gold standard for diagnosing atrial fibrillation. An electrocardiogram (ECG) records the electrical activity of the heart, which can show whether there are characteristics of atrial fibrillation: rapid, chaotic electrical activity in the atria and irregular beating of the ventricles.
For occasional or intermittent atrial fibrillation, your doctor may recommend wearing a Holter monitor to record an ECG for 24 hours or longer. This can capture arrhythmias that occur in a short period of time and help with diagnosis.
Echocardiogram (Echo) is an important test method for evaluating the structure and function of the heart. It can help doctors determine whether the atria are dilated, whether there are problems with the heart valves, and whether there are other heart diseases that may cause atrial fibrillation.
Blood tests are used to rule out other possible causes, such as hyperthyroidism or electrolyte imbalances, which may cause atrial fibrillation.
The goal of atrial fibrillation treatment is to control heart rate, restore normal heart rhythm and prevent complications. Treatment methods include drug therapy, non-drug therapy and surgical intervention.
Drug therapy is the main method to control atrial fibrillation. Common drugs include:
Anticoagulants: Atrial
fibrillation increases the risk of stroke, so anticoagulants (such as warfarin, direct oral anticoagulants DOACs such as apixaban, rivaroxaban, etc.) are often used to prevent thrombosis.
Antiarrhythmic drugs: Drugs used to restore and maintain normal heart rhythm (such as amiodarone, procainamide, etc.).
Beta blockers: These drugs help slow the heart rate and relieve palpitations.
Calcium channel blockers: Such as diltiazem, used to control heart rate.
Cardioversion is a treatment method that restores the heart's electrical activity to normal through electric shocks. It is often used to treat persistent atrial fibrillation. Cardioversion is generally used when the patient has not been able to restore normal heart rhythm through drug treatment.
Catheter ablation is another effective treatment for atrial fibrillation. An electric current is delivered to the atria through a catheter to destroy the area of abnormal electrical activity that causes the arrhythmia and restore the heart's normal rhythm. Catheter ablation is often considered for patients who do not respond to drug treatment or have recurrent atrial fibrillation.
For some extreme cases, surgical intervention may be required, such as the maze procedure for atrial fibrillation. This is a surgical procedure that removes part of the atrial tissue through heart surgery to block abnormal electrical activity. It is usually used for patients who do not respond to drug and catheter treatment.
In addition to drug treatment and surgical intervention, lifestyle adjustments are crucial to controlling atrial fibrillation. Avoiding excessive alcohol and caffeine, maintaining a healthy weight, controlling blood pressure and diabetes, and engaging in moderate exercise can help alleviate symptoms and reduce the risk of recurrence.
Although atrial fibrillation cannot be completely prevented, through early diagnosis and management, patients can effectively control symptoms, prevent complications, and improve their quality of life. Key preventive measures include:
Control underlying diseases: such as hypertension, diabetes, thyroid disease, etc.
Maintain a healthy lifestyle: balanced diet, moderate exercise, and quit smoking and limit alcohol.
Regular physical examinations: Regularly check heart health, especially for high-risk groups (such as hypertensive patients and the elderly).
Through these measures, patients can reduce the occurrence and development of atrial fibrillation, improve treatment effectiveness, and reduce adverse consequences.
Atrial fibrillation is a common and challenging heart disease, especially in developed countries such as the United States. With the increase in the elderly population, the incidence of atrial fibrillation is also increasing year by year. It not only affects the patient's quality of life, but may also lead to serious complications such as stroke and heart failure.
I hope this article can provide you with comprehensive information about atrial fibrillation and help you better understand and manage this heart disease.
