Atrial fibrillation is one of the most common heart rhythm conditions I see in clinical practice, yet it is often misunderstood. Many people first become aware of it after experiencing palpitations or during a routine health check. Understanding what atrial fibrillation is, how it affects the heart, and why it matters is important because early diagnosis and good management can significantly reduce long term risks. With clear information, people are better equipped to recognise symptoms and seek the right support.
What Is Atrial Fibrillation?
Atrial fibrillation, often shortened to AF, is a type of abnormal heart rhythm known as an arrhythmia. It happens when the upper chambers of the heart, called the atria, beat in an irregular and uncoordinated way. Instead of beating in a steady rhythm, the atria quiver or fibrillate. This disrupts the normal flow of blood through the heart and can affect how efficiently the heart pumps blood around the body. AF can be intermittent, where it comes and goes, or persistent, where the abnormal rhythm continues unless treated. Some people live with AF for many years, while others may only experience short episodes. The impact varies from person to person, which is why individual assessment is so important.
How Does Atrial Fibrillation Affect the Heart?
In a healthy heart, electrical signals follow a clear pathway that keeps the heartbeat regular. In atrial fibrillation, these signals become disorganised. The atria no longer contract properly, which means blood can pool inside the heart rather than moving smoothly into the lower chambers. This pooling increases the risk of blood clots forming.
The irregular rhythm can also cause the heart to beat too fast. Over time, this can strain the heart muscle and may lead to symptoms such as breathlessness or fatigue. In some cases, long standing atrial fibrillation can contribute to heart failure if not managed effectively.
What Causes Atrial Fibrillation?
There is no single cause of atrial fibrillation, but several factors increase the likelihood of developing it. High blood pressure is one of the most common contributors, as it changes the structure of the heart over time. Coronary heart disease, heart valve disease, and previous heart attacks can also affect the heart’s electrical system.
Other causes include long term lung disease, overactive thyroid, diabetes, and excessive alcohol intake. Some people develop AF without any obvious underlying heart disease, particularly as they get older. In these cases, age related changes in the heart can be enough to trigger the condition.
What Are the Symptoms of Atrial Fibrillation?
Symptoms vary widely. Some people notice strong palpitations, where the heart feels like it is racing, fluttering, or beating irregularly. Others feel short of breath, tired, or light headed. Reduced exercise tolerance is common, with everyday activities feeling more tiring than before. Importantly, some people have no symptoms at all. Their atrial fibrillation is only discovered during a routine check or when they are being assessed for another condition. Even without symptoms, AF still carries risks, which is why diagnosis and monitoring are important.
Why Is Atrial Fibrillation a Concern?
The main reason atrial fibrillation is taken seriously is because it increases the risk of stroke. When blood pools in the atria, clots can form. If a clot travels from the heart to the brain, it can block blood flow and cause a stroke. People with AF are several times more likely to have a stroke than those without it. AF can also affect quality of life by causing persistent symptoms and can contribute to heart failure if the heart is under ongoing strain. Effective management focuses on reducing these risks and controlling symptoms.
How Is Atrial Fibrillation Diagnosed?
Atrial fibrillation is usually diagnosed with an ECG, which records the electrical activity of the heart. If AF is intermittent, it may not show up on a standard ECG, so longer term heart rhythm monitoring may be needed. This can involve wearing a portable monitor for a period of time to capture abnormal rhythms. Blood tests and imaging such as echocardiography are often used to look for underlying causes and assess how the heart is functioning. Understanding the full picture helps guide treatment decisions.
What Types of Atrial Fibrillation Are There?
AF is often described based on how long it lasts and how it behaves.
Paroxysmal atrial fibrillation comes and goes, with episodes that stop on their own.
Persistent atrial fibrillation lasts longer and usually needs treatment to restore normal rhythm.
Permanent atrial fibrillation is ongoing and managed by controlling the heart rate rather than restoring rhythm.
How Is Atrial Fibrillation Treated?
Treatment is tailored to each individual and focuses on two main areas. One is controlling the heart rate or rhythm to reduce symptoms. The other is reducing stroke risk. Medications are commonly used to slow the heart rate or maintain a more regular rhythm. Some people may benefit from procedures such as cardioversion, where the heart rhythm is reset, or catheter ablation, which targets areas causing abnormal electrical signals. Stroke prevention is a key part of treatment. Many people with AF are prescribed blood thinning medication to reduce the risk of clots forming. The decision to use these medicines is based on individual risk factors and careful assessment.
How Can Atrial Fibrillation Affect Daily Life?
Living with atrial fibrillation can be challenging, particularly if symptoms are frequent. Fatigue and breathlessness can affect work, exercise, and social activities. Some people feel anxious when palpitations occur. With the right treatment and support, many people manage AF well and continue to live active lives. Lifestyle factors also play a role. Reducing alcohol intake, managing stress, maintaining a healthy weight, and staying active all support better heart rhythm control. Regular follow up helps ensure treatment remains effective over time.
When Should You Seek Medical Advice?
You should seek medical advice if you notice new palpitations, worsening breathlessness, dizziness, or unexplained fatigue. If you experience symptoms of stroke such as facial drooping, arm weakness, or speech difficulty, emergency help is essential. Even if atrial fibrillation has already been diagnosed, changes in symptoms should always be reviewed.
Conclusion
Atrial fibrillation is a common but serious heart rhythm condition that deserves careful attention. With early diagnosis, appropriate treatment, and regular monitoring, the risks can be significantly reduced and symptoms well controlled. If you are experiencing symptoms, have concerns about an irregular heartbeat, or want personalised advice about atrial fibrillation, you can always contact us here. You can also book an appoint by using our phone line on 0208 255 5999.
