Main
- Atrial fibrillation — chaotic contraction of the atria, in which blood stagnates and the ventricles work unevenly.
- Causes: high blood pressure, ischaemic heart disease, previous heart attack, heart defects, thyroid disease, alcohol.
- Symptoms: palpitations and a sinking feeling in the heart, irregular heartbeat, shortness of breath, weakness, dizziness, chest discomfort.
- Diagnosis: electrocardiography at rest, 24-hour and long-term rhythm monitoring, echocardiography, blood tests.
- The condition is managed by a cardiologist; if other methods are ineffective, a cardiac surgeon is involved; visits should be regular.
What is atrial fibrillation
Atrial fibrillation is a heart rhythm disorder in which the atria contract chaotically and ineffectively. This condition can cause a feeling of palpitations and requires monitoring by a specialist.
What happens in the body
Normally, the atria contract in a coordinated and orderly manner, following the rhythm set by the sinus node. In atrial fibrillation, this order is disrupted: instead of a single clear signal, multiple erratic impulses pass through the atria. As a result, the muscle fibres contract out of sync, each at its own pace, and no coordinated push occurs. Blood in the atria stops moving evenly and begins to linger, stagnating in certain areas. The ventricles also work unevenly, because an irregular flow of signals reaches them. A person may notice this as a feeling of palpitations, a pause, or thuds in the chest, although the severity varies. Therefore, when such sensations appear, it is important not to ignore them and to discuss them with a doctor.
What causes it
- High blood pressure: constant stress on the heart walls changes their structure and creates conditions for a rhythm disorder, so it is important to keep blood pressure under control.
- Coronary heart disease and a previous heart attack: areas of the heart muscle damaged by insufficient blood flow lose normal conductivity and become a source of rhythm disturbances.
- Heart valve disease and inflammatory heart diseases: changes in the valves and inflammation disrupt the anatomy of the chambers, causing the electrical signal to spread incorrectly.
- Thyroid disease with increased function: an excess of its hormones speeds up metabolic processes and alters the heart's function, which often affects the rhythm.
- Alcohol abuse: alcohol directly affects the excitability of the heart muscle, and regular large doses increase the likelihood of rhythm disturbances.
- Older age and a hereditary predisposition: over the years, age-related changes accumulate in the heart, and a family history indicates an increased tendency to this disorder.
Who experiences it more often
Older people, in whom age-related changes accumulate in the heart over the years, experience rhythm disorders more often. Their muscle tissue becomes denser, recovery processes are slower, so the coordinated work of the atria is disrupted more easily. The likelihood is noticeably increased by conditions that have accompanied the person for a long time: high blood pressure, coronary heart disease, a previous heart attack. Heart valve disease, inflammatory heart diseases and thyroid disorders with increased function also contribute. Alcohol abuse, which directly affects the excitability of the heart muscle, should be considered separately. A hereditary predisposition also plays a role: if close relatives have had similar rhythm disorders, it is worth being more attentive to one's own condition. Therefore, if several such circumstances are present, it is reasonable to discuss with a doctor whether regular monitoring of heart function is needed.
What symptoms can there be?
Atrial fibrillation manifests in different ways: from mild discomfort to pronounced sensations. Some people do not notice the symptoms and learn about the rhythm disorder by chance at a doctor's appointment.
How it is noticed at the very beginning
At the beginning, atrial fibrillation is often felt as missed beats or a pause in the heart, which a person attributes to tiredness after a working day. The heartbeat becomes irregular or rapid, and this is noticed even at rest. Shortness of breath appears with usual exertion that previously was easy, for example when climbing stairs. Rapid fatigue and weakness increase gradually, so they are easily explained by lack of sleep or a stressful week. Dizziness and a near-fainting state occur suddenly and make a person stop and sit down. Discomfort or pain in the chest adds to the overall picture and increases anxiety about one's condition. If such signs recur, it is worth writing down when they occur and showing these notes to a cardiologist.
Signs that occur most often
- Missed beats and pauses in the heart: a person feels pauses or thuds in the chest, and this is one of the most common reasons for seeing a doctor.
- Rapid or irregular heartbeat: the rhythm goes off without an obvious cause, which is noticeable at rest and with slight exertion.
- Shortness of breath: breathing becomes difficult with exertion or even at rest, making usual tasks harder.
- Rapid fatigue and weakness: strength runs out faster than usual, and a person cannot do what they previously did without effort.
- Dizziness and a near-fainting state: a feeling of unsteadiness appears, in which it is important to stop the exertion and sit down.
- Discomfort or pain in the chest: unpleasant sensations in the chest require attention, because they may accompany a rhythm disorder.
When to seek help urgently
Examinations and tests
Examination for atrial fibrillation is built from simple to complex. First, the doctor talks to the patient and examines them, and then selects methods that will confirm the rhythm disturbance and show its cause.
How the examination begins
Atrial fibrillation is recognised by complaints, medical history and examination findings. The doctor asks in detail about how long ago and under what circumstances interruptions in the heart's work occur. He clarifies what illnesses the person has had before and what is troubling them now. During the examination, the specialist listens to the heart and assesses the pulse in order to notice irregularity in its filling. Then the doctor measures blood pressure and examines the skin, limbs and neck area. This information helps to understand how long the rhythm disturbance has existed and how it affects the general condition. The main method of confirmation remains recording the electrical activity of the heart, and sometimes it has to be carried out over a long period. The patient should recall and write down in advance exactly when episodes of rapid or irregular heartbeat occurred.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: take medical documents from other institutions so that the doctor can see the full picture of your health over past years.
- Previous tracings: bring old recordings of the heart's electrical activity, if they have been preserved, because comparison helps to assess changes.
- Observation diary: write down when the interruptions occurred, what you were doing at that moment and how long they lasted, this clarifies the picture.
- List of complaints: list in advance everything that is troubling you, including weakness, breathlessness and dizziness, so that nothing is forgotten at the appointment.
- List of illnesses: prepare information about past diseases and operations, since they influence the choice of examinations.
- Questions for the doctor: formulate in advance what you want to clarify, this way you will get answers and go through the examination more calmly.
Which doctor should I see?
In atrial fibrillation, care is provided by a cardiologist, and if necessary a cardiac surgeon is brought in. Below — who to see, what happens at the appointment and what treatment consists of.
Which specialist manages this condition
Atrial fibrillation is managed by a cardiologist, and under certain circumstances a cardiac surgeon is brought in for follow-up. The cardiologist provides the main follow-up, assesses how the patient feels and the duration of the rhythm disorder. They also take into account concomitant diseases that influence the choice of approach to care. A cardiac surgeon is brought in when surgery is being discussed because other methods have been ineffective. If there is no specialist nearby, it is worth starting with a general practitioner, who will refer you to the right specialist. At the first appointment, the doctor clarifies the complaints, the history of the rhythm disorder and past illnesses. Then they determine what is required in the specific case and arrange a follow-up visit. Do not postpone the visit if the interruptions in the heart's work have become more noticeable or more frequent.
What treatment consists of
- Selection of therapy: the doctor chooses whether to control the heart rate or restore the rhythm, guided by how the patient feels and the duration of the disorder.
- Prevention of blood clot formation: a separate area of care that the specialist prescribes according to indications in order to reduce the risk of complications.
- Procedures to restore the rhythm: used when there are indications for them, and the decision is made by the doctor based on the results of follow-up.
- Surgery: discussed by the cardiac surgeon if other methods have proved ineffective and the condition requires a different approach.
- Follow-up with a cardiologist: regular visits and adjustment of treatment over time, since the condition and how the patient feels may change.
What depends on the patient themselves
Regular follow-up with a cardiologist is the part of the result that rests on the patient themselves. If visits are missed, the doctor does not see how the condition is changing and cannot adjust care in time. This can be noticed by the fact that the interruptions in the heart's work become more frequent or more noticeable, and the usual state of health changes. Then the adjustment of treatment is delayed, and it becomes harder to select a suitable approach. A simple habit helps: writing down when the interruptions occur, how long they last and what preceded them. Such notes at the appointment give the doctor more than general words about how you feel. Come to the scheduled visits and report any changes, even if they seem insignificant. A steady rhythm of visits gives the doctor a basis for decisions, and gives you fewer surprises.
What helps prevent an exacerbation?
Preventing exacerbations of atrial fibrillation is largely helped by a person's everyday behaviour and attention to concomitant diseases. Below — about habits, indicators and regularity of visits to the doctor.
What is changed in habits
Limiting alcohol noticeably reduces the likelihood of repeated episodes of rhythm disturbance in many people. Smoking worsens the condition of blood vessels and the heart, so giving it up is part of the basic recommendations for this condition. Regular physical activity is selected according to how you feel, without overload and sudden bursts. Excess weight and a sedentary lifestyle maintain elevated blood pressure and metabolic disorders. A diet with limited salt and saturated fats helps keep blood pressure and cholesterol within calmer limits. Sleep and daily routine also affect the rhythm: lack of sleep and overwork often coincide with a worsening of how you feel. It is worth discussing with the doctor which activities are acceptable in your particular case, so as to move without risk.
What should be kept under control
- Blood pressure: it is measured regularly and recorded, because pressure surges often go hand in hand with attacks.
- Cholesterol level: it is checked as prescribed by the doctor, since changes in metabolism affect the condition of blood vessels and the heart.
- Thyroid diseases: they are treated in good time, as the work of the gland is reflected in the heart rate.
- Heart diseases: their monitoring and correction help reduce the load on the rhythm and overall well-being.
- Your own sensations: interruptions, weakness and shortness of breath should be recorded, so as to show the notes to the doctor at the appointment.
How often to see the doctor
Regular visits to the doctor are needed even when you feel quite well and nothing is troubling you. Concomitant diseases can change imperceptibly, and their control directly affects the risk of exacerbations. At the appointment the doctor assesses blood pressure, pulse, general condition and, if necessary, adjusts the monitoring. The frequency of visits depends on the course of the condition and concomitant diseases, so it is determined by the doctor individually. Between appointments it is useful to keep a diary of how you feel and note episodes of interruptions, weakness or shortness of breath. If new complaints appear or your usual condition changes, the visit should not be postponed until the planned date. This order helps to notice changes in time and discuss further steps with the specialist.
What is worth remembering
Atrial fibrillation is a condition in which the heart rhythm becomes irregular and it is important to keep it under a doctor's supervision. Below is what is worth taking away from this material and applying in your own life.
Key takeaways
Atrial fibrillation is not always felt as an obvious malaise, so it is often found by chance during an examination or an ECG. A person may put irregularities in the heart's work down to fatigue, stress or lack of sleep and thereby postpone a visit to a specialist. Meanwhile, it is early seeking of help that allows the condition of the heart to be assessed in time and suitable monitoring to be selected. Atrial fibrillation requires not a one-off visit but regular monitoring, since its course can change over time. The person themselves also plays a noticeable role: sleep routine, giving up strong alcohol and blood pressure control help to reduce the frequency of flare-ups. If the episodes become more frequent or more severe, this is a reason not to wait for a scheduled appointment but to seek help earlier. The support in making a decision is not independent attempts to figure things out, but an honest conversation with a doctor about how you feel.
