Atrial Fibrillation

Atrial fibrillation is an irregular and very rapid heart rhythm that can cause blood clots in the heart which can increase the risk of having a stroke, or heart failure.

During atrial fibrillation, the upper chambers of the heart (atria) beat irregularly and out of sync with the lower chambers of the heart (the ventricles).

Atrial fibrillation can happen in episodes that come and go, or it may be persistent. A-fib itself usually is not life-threatening, however, it requires proper treatment to prevent stroke.


To understand the causes of atrial fibrillation, we have to understand how the heart beats. The heart has 4 chambers (Upper chambers: right and left atria, and lower chambers: right and left ventricles). In the right atrium there is a structure called the sinus node, which is the pacemaker of the heart that signals each heartbeat. In atrial fibrillation, the sinus node sends chaotic signals that cause loss of synchronization between the atria and the ventricles which leads to the abnormal heart rhythm and atrial fibrillation. Usually this can happen as a result of many causes that affect the sinus node such as:

Heart attackCoronary artery diseaseCongenital heart diseaseHeart valve problemsLung diseaseHigh blood pressurePrevious heart surgerySick sinus syndromeThyroid gland diseaseUse of certain medications and stimulants such as tobacco, alcohol and caffeineSome viral infections can also cause itAlso sleep apnea can cause atrial fibrillation


Sometimes people who have atrial fibrillation don’t notice any symptoms, however those who are symptomatic can have any some signs and symptoms such as:

Sensation of heart racing, or pounding heartbeat (palpitations)

DizzinessChest painFatigueLightheadednessReduced energy during exercise Shortness of breathWeakness Shortness of breath


Diagnosis of Atrial fibrillation can be coincidental because some people may not have symptoms. Your doctor may detect it while listening to your heart or checking your heart rate for another reason. Once suspected, then your doctor may order additional tests to diagnose such as:

Electrocardiogram (EKG), which is a quick test to measure the electrical activity of your heart and record your heart rate and rhythm. EKG is the main test to diagnose atrial fibrillation

Blood tests can be ordered to rule out other causes such as thyroid problems

Your doctor can also order “Holter Monitor” which is a pocket device you take home that records the heart rhythm and rate for 24 hours or longer

Your doctor can order an Echocardiogram which is a non-invasive test that uses sound waves to create images of the heart movement, structure and size

Also a heart stress test can be ordered to assess the function of the heart and detect any structural abnormalities


The treatment of atrial fibrillation depends on how long you have had the symptoms and the underlying cause of the heart problem. The main goals of the treatment is to prevent strokes and control the heart rhythm and rate. This can be achieved through medications, through resetting the heart rhythm (cardioversion) or even through a heart catheterization or surgery.

For medications: your doctor may prescribe certain medications to control atrial fibrillation such as:

Beta blockers which help controlling the heart rate and slow it down during rest and during activity

Calcium channel blockers to control the heart rate and blood pressure

Digoxin is a medication that controls the heart rate during rest, but not during activity

Anti-arrhythmic medications: are drugs that control the heart rhythm, but they are not commonly used because they have more unfavorable side effects

Blood thinners are very important because they lower the risk of getting a stroke or blood clots. These include drugs such as Warfarin and Apixaban

If medications are not effective enough, then Cardioversion therapy is considered, especially if the symptoms are persistent. Cardioversion is an intervention that resets the rhythm of the of the heart to normal, it can be achieved with electrical cardioversion or drug cardioversion. It is usually done in the hospital.

Heart catheterization and surgery are considered if atrial fibrillation is not responding to medications or cardioversion. The doctor might recommend a procedure called “cardiac ablation” which uses a scar in the heart that block abnormal electrical waves and stimulate normal heart rhythm again


Unfortunately, not all cases of atrial fibrillation can be prevented, however all steps to avoid coronary artery disease or high blood pressure can help prevent atrial fibrillation.

You can consider the following steps a healthy heart and vascular system:

Stop smokingEat healthy, avoid fast food and fatty foodExercise regularlySleep wellKeep your stress levels downKeep your weight healthy