What Is Atrial Fibrillation?

Atrial Fibrillation

Arrhythmia refers to fast, slow, or irregular heartbeats. Atrial fibrillation (AFib) is the most common abnormal heart rhythm. It is often very rapid (sometimes called tachycardia).

During atrial fibrillation, the heart's upper chambers, called the atria, beat chaotically and irregularly. They beat out of sync with the lower heart chambers (ventricles). This may result in a fast, pounding heartbeat, shortness of breath, or light-headedness. However, some people may have no symptoms at all.

Episodes of atrial fibrillation may occur sporadically, or they may be constant. AFib itself usually isn't life-threatening, but it is a serious condition that requires treatment to prevent a stroke or other heart issues from occurring. Treatment may include medication, shock therapy to restore the heart to a normal rhythm, or procedures to block these faulty heart signals.

Symptoms of Atrial Fibrillation

Symptoms of Afib may come and go with varying frequency or become more noticeable as your condition worsens. Common symptoms include:

Extreme fatigue (the most common symptom of AFib)
Chest pain
Difficulty breathing, especially when lying down
Shortness of breath
Dizziness, lightheadedness or fainting
Heart palpitations, fluttering or pounding
Irregular heartbeat
Low blood pressure

If you are experiencing any of these symptoms, do not ignore them - speak with your doctor. Your doctor can diagnose Afib and its effects on your health, even if you have none of these symptoms.

Causes of Atrial Fibrillation

Your heart pumps blood throughout your body. Electrical impulses control the speed and regularity of your heartbeat, ensuring the process runs smoothly. When something disrupts the process, it can slow or block electrical signals, which in turn affects your heartbeat.

With AFib, the signals in the upper chambers of the heart are chaotic, causing them to tremble or quiver. This causes a fast and irregular heart rhythm that, in some people, may exceed 200 heartbeats a minute.

The risk of AFib increases as you get older. AFib may be caused by medical conditions or lifestyle habits, including the following:

Health Conditions:

Abnormal potassium levels
Family history and genetics
Heart disease, including heart failure
Kidney disease
Obesity
Sleep apnea
Overactive thyroid gland

Lifestyle Habits:

Moderate to heavy alcohol consumption
Consuming large amounts of caffeine
Smoking or tobacco use
Illegal drug use, including amphetamines and cocaine
Certain medications that contain stimulants, including cold and allergy medicines

Do Occasional Heart Flutters Mean You Have AFib?

While heart flutters are a symptom of AFib, they do not necessarily mean you have atrial fibrillation. Stress, diet, exercise, smoking and other lifestyle habits can cause heart flutters. However, you should not dismiss heart flutters, which may indicate a more serious health condition. Speak with your doctor, who can rule out or diagnose AFib or other cardiac issues.

Diagnosing AFib

AFib is commonly diagnosed by an electrophysiologist, a specialized cardiologist who diagnoses and treats heart rhythm disorders. This will include a physical exam, a blood pressure check, and a discussion of your lifestyle habits and medical and family history. Additional tests may include:

Electrocardiogram (EKG) to measure heart rate
Exercise stress tests to show how the heart reacts to exercise
Wearing a monitor that records the signals from your heart over several days
Imaging tests including CT and MRI scans to view images of the heart’s structure

Electrophysiology (EP) Study

Your cardiologist may also perform an EP (electrophysiology) study to obtain information to help diagnose and locate the source of an arrhythmia. The electrophysiologist guides thin catheters to the heart through small incisions. The catheters deliver and record electrical signals at specific locations in the heart muscle. Using information from the EP study, cardiologists can determine the location of the irregularity and recommend the most appropriate treatment.

AFib Treatments

The main goal of treatment for AFib is the prevention of stroke and focuses on resetting and controlling the heartbeat and preventing blood clots. Treatments may include prescription medications like blood thinners, beta blockers, and calcium channel blockers. Minimally invasive procedures may include:

Catheter-Based Radiofrequency Ablation

Catheter ablation therapy has become the standard in the invasive management of atrial fibrillation.

“Advanced mapping technologies are used to precisely locate abnormal heart tissue that causes irregular heart rhythms such as atrial fibrillation. We now use a combination of radiofrequency ablation and, more recently, state-of-the-art energy delivery modalities such as pulsed field ablation, allowing us to more accurately target these areas while avoiding damage to collateral tissues, providing both more effective and safer treatments than ever before.”

Dr. Joseph Germano, DO, Regional Director of Electrophysiology at Catholic Health

Pacemakers and Defibrillator Implantation

Pacemakers and implantable cardioverter defibrillators are used to manage abnormal cardiac rhythms. These devices are placed under the skin of the chest and attach to the heart using thin wires fed through blood vessels.

In general, pacemakers are used to treat slow heart rhythms, and defibrillators are used to treat dangerous heart rhythms originating from the bottom of the heart. Although these conditions differ from Afib, they often occur in the same patients.

Surgical Ablation (Mini-Maze)

This minimally invasive procedure uses different energy sources to create lines of ablation along the exterior of the heart. The result is scar tissue that interrupts the faulty electrical pathway that causes the irregular rhythm.

Your cardiologist will determine which treatment plan is best for you.

Comprehensive Care for AFib

The award-winning cardiology services offered at the St. Francis Heart Center are available at Catholic Health hospitals and health care practices across Long Island, providing convenient access to award-winning cardiac care.

Our physicians are nationally recognized cardiologists who specialize in advanced diagnostics and treatment for atrial fibrillation and other heart arrhythmias. Their clinical excellence and compassionate care help patients improve their quality of life.