What is Atrial Fibrillation? Understanding Causes, Symptoms, and Treatment

Paroxysmal Atrial Fibrillation

This type occurs in brief episodes, lasting less than 7 days, typically resolving within 24 hours. Patients often experience symptoms such as palpitations, chest discomfort, and shortness of breath. Although the episodes are short-lived, repeated occurrences increase the risk of stroke.

Persistent Atrial Fibrillation

This type of atrial fibrillation lasts longer than 7 days but may still revert to normal rhythm through medication or electrical cardioversion. Due to its prolonged duration, there is an increased risk of heart failure.

Permanent Atrial Fibrillation

In this case, atrial fibrillation persists for more than a year and typically cannot be restored to normal rhythm through medication or electrical cardioversion. Long-term atrial fibrillation can lead to structural changes in the heart, increasing the complexity of treatment.

Structural Changes in the Heart / Reduced Chamber Size

When the heart endures prolonged pressure, such as from high blood pressure or valvular heart disease, the atria can gradually enlarge. As the atria expand, the internal space increases, lengthening the pathway for cardiac electrical signals, which can lead to disturbances and result in atrial fibrillation.

Additionally, certain congenital heart conditions or changes following heart surgery may cause the atrial diameter to decrease. This can obstruct blood flow, increasing the risk of clot formation, which can trigger atrial fibrillation.

Stiffening of the Myocardial Wall

Myocardial disease can cause the heart muscle to thicken and become rigid, affecting the normal contraction of the atria and increasing the risk of atrial fibrillation.

Individuals with atrial fibrillation may experience the following symptoms:

• Palpitations
• Chest discomfort
• Shortness of breath
• Fatigue
• Dizziness
• Fainting

Symptoms of atrial fibrillation can vary widely and differ from person to person; some patients may even have no noticeable symptoms. However, even in the absence of obvious symptoms, atrial fibrillation still increases the risk of stroke. This is because blood can easily form clots in the atria during fibrillation; if a clot dislodges and blocks a blood vessel in the brain, it can lead to a stroke.

• Alcohol Consumption

Alcohol can cause blood vessel constriction and increase the burden on the heart, potentially harming it over time.

• Age

With increasing age, cardiac tissues gradually age, making structural changes in the atria more likely, thus raising the risk of atrial fibrillation.

Hypertension

High blood pressure adds stress to the heart, possibly leading to hypertrophy of the myocardium and atrial enlargement, resulting in atrial fibrillation.

• Gender

Male hormones may be linked to the occurrence of atrial fibrillation, making men more susceptible to the condition.

• Hyperthyroidism

An overactive thyroid can accelerate heart rate, increasing the oxygen demand on the heart and negatively impacting its health.

• Genetics

Individuals with a family history of atrial fibrillation have a higher risk of developing the condition.

Atrial fibrillation may show no symptoms until a stroke occurs, which could be too late for intervention. If you suspect you have atrial fibrillation, you can conduct a simple self-assessment: gently press your fingers on the inner wrist or neck to feel your pulse. If you notice an irregular or abnormal pulse rate, it's advisable to seek medical attention for a professional diagnosis and advice.

Generally, atrial fibrillation cannot be completely cured, but with appropriate treatment, the condition can be managed effectively.

Medication Treatment

Antiarrhythmic Drugs These medications can help regulate heart rate and effectively control the rhythm, preventing the occurrence of atrial fibrillation.

Anticoagulant Therapy

To prevent strokes in patients with atrial fibrillation, doctors often prescribe anticoagulants. These medications effectively reduce blood clotting, lowering the risk of clot formation and subsequent stroke.

Electrical Cardioversion

For acute episodes of atrial fibrillation, electrical cardioversion may be used to restore normal heart rhythm. This process may involve discomfort and has a relatively high recurrence rate.

Catheter Ablation

This is a more advanced treatment that involves ablating (burning) abnormal conduction pathways in the heart to achieve long-term control of atrial fibrillation.

The cardiologists and healthcare team at Hong Kong Adventist Hospital strive to provide comprehensive, caring one-stop cardiovascular services, including heart examinations, outpatient care, treatments, surgeries, and rehabilitation services.

If untreated, atrial fibrillation can lead to a range of severe complications that significantly impact health, including:

• Stroke
• Heart failure
• Cardiac arrest
• Cognitive decline
• Increased mortality rate

To prevent or detect atrial fibrillation early, regular heart examinations are crucial. Traditional methods like electrocardiograms (EKG), blood tests, and CT scans are effective diagnostic tools. However, with recent technological advancements, convenient self-monitoring tools, such as mobile ECG monitors, have emerged. These allow individuals to easily monitor their heart rhythm at home or during daily activities, providing continuous oversight of their cardiac health.

In addition to regular checkups, adopting a healthy lifestyle is key to preventing atrial fibrillation:

• Balanced Diet: Consume more fruits, vegetables, and whole grains while reducing saturated fats, trans fats, sugars, and salt.
• Regular Exercise: Engage in moderate physical activity to maintain heart health and control weight.
• Quit Smoking and Limit Alcohol: Both smoking and excessive alcohol can significantly harm the heart.
• Weight Management: Maintaining a healthy weight helps reduce the burden on the heart.