Atrial fibrillation (Afib) is a cardiac arrhythmia that usually occurs in heart disease or during drug therapy. Those affected suffer from palpitations, shortness of breath and dizziness. Atrial fibrillation can be cured in over 95 percent of cases.

Atrial fibrillation

Article Overview

1. Description
2. symptoms
3. Causes and risk factors
4. Diagnosis and examination
5. Treatment
6. Course of the disease and prognosis


Atrial fibrillation: Description

Atrial fibrillation is a rhythm disorder that originates from the right atrium of the heart. In atrial flutter, the electrical signal from the sinus node “goes astray” and forms what is called circular excitations in the right atrium. This stimulates the atria up to 300 times per minute. The electrical signals are also transmitted to the ventricles. However, in the conduction system of the heart, there is protection (a so-called block by the AV node) against too fast excitations. Only every second, third or fourth signal is actually passed on to the muscle cells of the ventricles. The heart then beats up to 150 times per minute.

Sometimes this blocking of electrical excitations stops. Then so many excitations are transmitted to the ventricles that they beat at a rate of up to 300 per minute. The affected person then quickly becomes unconscious.

Atrial fibrillation: Symptoms

Because the heart beats very fast in Atrial fibrillation (more than 150 times per minute), sufferers almost always feel an uncomfortable racing and thumping heart. They feel tired, breathless and dizzy. Many feel pressure on the chest. The rhythm disturbance usually begins suddenly. The pulse is fast and regular.

Atrial fibrillation: Causes and risk factors

Most often, Atrial fibrillation occurs when the heart is weakened by coronary artery disease, inflammation, or after heart surgery. Very rarely, Atrial fibrillation can occur without a specific trigger.


Atrial fibrillation: Diagnosis and examination

It is usually sufficient for the doctor to make a so-called electrocardiogram (ECG). Electrodes placed on the chest are used to record the heart’s electrical activity, which is then recorded by a recorder. Sometimes the ECG must be written over a period of 24 hours or longer to document Atrial fibrillation.

Depending on the pattern of the circling excitations, there is typical Atrial fibrillation or atypical Atrial fibrillation. Typical atrial flutter is visible on the ECG by a “sawtooth” pattern of heatwaves.

If Atrial fibrillation cannot be diagnosed by an ECG, a so-called electrophysiological examination can be performed. It is similar to cardiac catheterization. Here, an electrode catheter is advanced to the heart via a groin vein. It measures the electrical excitation directly at the heart. If atrial flutter is detected during the examination, it can be treated while the examination is still in progress.

Atrial fibrillation: Treatment

Atrial fibrillation can be stopped for a time by a procedure called electro cardioversion. This therapy method is similar to defibrillation during resuscitation. First, two electrodes are attached to the patient’s chest. The patient is then anesthetized. The doctor then sends a short electric shock through the patient’s heart via the electrodes. The electric shock usually causes it to fall back into the correct rhythm. All of the patient’s vital signs are monitored. However, after cardioversion, atrial flutter usually returns after some time.

If Atrial fibrillation occurs more frequently, so-called catheter ablation can cure the affected person. For this purpose, an electrode catheter is guided to the heart via the inguinal vein. The catheter can be used to obliterate the area where the Atrial fibrillation develops. The cure rate with this treatment method is more than 95 percent.

Atrial fibrillation: Course of the disease and prognosis

In almost all cases, Atrial fibrillation can be cured by catheter ablation. However, the prognosis is particularly dependent on the heart disease that triggered the Atrial fibrillation.

Atrial fibrillation is only sometimes dangerous if the excitations are transmitted one-to-one to the ventricles. Rarely, after medication, atrial flutter changes into so-called Atrial fibrillation.

Since Atrial fibrillation increases the risk of stroke, sufferers often need to be given blood-thinning medication. If ablation has been successful, blood-thinning treatment for Atrial fibrillation is usually no longer necessary.

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