The atria of the heart are the upper chambers, there's one atrium on either side. Atrial fibrillation (AFib) and atrial flutter are two types of abnormal heart rhythms (arrhythmias) that affect these chambers.
AFib is the most common kind of treated arrhythmia. The heart's atria beat irregularly, and the blood flows improperly from the atria to the lower chambers of the heart (ventricles). This condition can happen chronically or in episodes.
The four main types of atrial fibrillation are called paroxysmal, persistent, long-term persistent, and permanent. The distinctions among these 4 kinds of AFib are mainly about how long they last.
- Paroxysmal AFib describes a brief event of atrial fibrillation, a paroxysm, which usually ends within a 24 hour period, but can last for a week. Paroxysmal atrial fibrillation can happen repeatedly.
- When paroxysmal AFib alternates with bradycardia, a slow heart rate, the condition is called tachybrady syndrome.
- Persistent atrial fibrillation lasts for more than a week.
- Long-term persistent atrial fibrillation lasts for more than a year.
- Permanent atrial fibrillation is a chronic condition that does not improve, despite trying to reestablish a normal heart rhythm multiple times with treatments.
Not everyone with AFib experiences symptoms, which can sometimes make it a difficult condition to recognize. Those who do have symptoms may have an irregular heartbeat, heart palpitations, fatigue, shortness of breath, angina (chest pain), or lightheadedness.
Risk Factors for atrial fibrillation include family history, lifestyle habits like stress, smoking, overexertion in exercise, the use of certain illegal drugs, and drinking alcohol. There are a number of other conditions which raise one's risk of atrial fibrillation, like heart failure, sarcoidosis, and sleep apnea, among others. The risk of AFib also increases with age, particularly after the age of 65.
AFib is usually diagnosed with the help of certain tests. Your doctor may start by simply checking your pulse and heart rate. In our offices we use EKGs, Holter monitors, and implantable loop recorders to screen for arrhythmias like atrial fibrillation and atrial flutter. While an EKG, electrocardiogram, does check the heart's rhythm, it only does so for a short period of time during an office visit. Holter monitors and implantable loop recorders can monitor for these conditions for a much longer time, in case they only occur occasionally, as with paroxysmal AFib.
Certain medications can be used to treat AFib, like beta blockers, blood thinners, and calcium channel blockers. Beta blockers slow the heart rate, which can be important for allowing the heart's lower chambers, the ventricles, to properly fill with blood. Blood thinners are often a part of a treatment plan for AFib because they help to prevent blood clots, which can lead to life-threatening conditions. Calcium channel blockers, like beta blockers, help change the rate of the heart's lower chambers's pumping.
There are also surgical options for treating atrial fibrillation. Catheter ablations, surgical ablations, cardioversion, or a pacemaker are all treatment options for this condition.
There are certain lifestyle changes which aim to improve the risk factors related to lifestyle which can lead to AFib. In order to prevent AFib, your doctor may recommend controlling blood sugar, limiting alcohol, stopping the use of certain illegal drugs, managing stress, quitting smoking, and aiming for a healthy blood pressure and a healthy weight. Your doctor may also recommend certain medications for heart surgery to prevent arrhythmia.