What is atrial fibrillation?

Atrial fibrillation is a type of heart arrhythmia (abnormal heartbeat). Atrial fibrillation is when your atria (the upper chambers of your heart) twitch or 'fibrillate' rather than pump normally.

When you have atrial fibrillation, your heartbeat may be fast and not regular. This is because there is a problem with the electrical pathways that control your heart rhythm.

Atrial fibrillation is also known as AF or AFib.

Atrial fibrillation can:

• happen as a one-off episode
• come and go
• persist over time

Paroxysmal atrial fibrillation is when atrial fibrillation starts and stops suddenly.

Atrial flutter is another heart rhythm problem that is a lot like atrial fibrillation. However, if you have atrial flutter your heart will beat in a fast, but regular way.

What are the symptoms of atrial fibrillation?

Some people with atrial fibrillation have no symptoms. Others may:

• have breathing problems
• feel dizzy or lightheaded
• have heart palpitations (this may feel like your heart is racing or beating too fast)
• feel weak or tired
• have chest pain or discomfort
• have difficulty exercising

If your heart is in atrial fibrillation, your pulse will be irregular.

What causes atrial fibrillation?

Atrial fibrillation is the most common kind of heart arrhythmia. It can run in families and gets more common as you get older.

You are more likely to develop atrial fibrillation if you:

• have metabolic syndrome, diabetes or high blood pressure
• are overweight
• are a smoker or drink excess alcohol
• have obstructive sleep apnoea
• have coronary heart disease
• have heart valve disease
• have heart failure or kidney failure

A less common cause is hyperthyroidism (an overactive thyroid gland).

If you have major surgery or a serious infection, this could trigger an episode of atrial fibrillation.

When should I see my doctor?

If you have symptoms that may be atrial fibrillation, it's important to see your doctor. Atrial fibrillation can have serious consequences.

How is atrial fibrillation diagnosed?

If you have symptoms of atrial fibrillation, your doctor will talk with you and examine you.

Atrial fibrillation is usually diagnosed using an electrocardiogram, or ECG.

Your doctor may order other tests such as:

• a 24-hour heart monitor (called a Holter monitor)
• an echocardiogram (heart ultrasound)

You might also need some blood tests.

How is atrial fibrillation treated?

Treatment for AF will depend on your symptoms, the cause and what other health conditions you have.

There are several treatments for atrial fibrillation:

• Medicines to help your heart go back to a normal rhythm or to slow your heart rate.
• Cardioversion — an electrical shock is given to your heart to reset normal rhythm. This is done under general anaesthetic.
• Catheter ablation — this procedure destroys (ablates) the area inside the heart that is causing the abnormal rhythm.
• Pacemaker — a small implanted device that stimulates the heart to beat regularly.

Medicines to prevent a stroke are also usually recommended — see Complications below.

Long-term management of atrial fibrillation

If you have atrial fibrillation, you can help by avoiding triggers and looking after your heart. Take all your medicines as prescribed, look after your general health, and visit your doctor regularly.

Try to follow a healthy lifestyle by:

• eating healthily
• staying physically active — talk to your doctor about the right amount of exercise for you
• maintaining a healthy weight
• not smoking
• limiting or avoiding alcohol and caffeine
• managing diabetes and any other health conditions you might have

Complications of atrial fibrillation?

There can be serious complications of atrial fibrillation.

When the electrical pathways in the heart are not working well, your heart can't pump blood smoothly. This increases the chance of a blood clot forming in the heart. If a blood clot forms and travels to the brain, it can cause a stroke.

Medicines to prevent stroke are usually recommended for people with atrial fibrillation. These medicines work by reducing the risk of blood clotting.

Resources and Support

Visit the Heart Foundation for patient resources and support.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.