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Atrial fibrillation

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  • 2021-01-31

Atrial fibrillation is one of the most common types of arrhythmias, which are irregular heart rhythms. Atrial fibrillation causes your heart to beat much faster than normal. Also, the upper and lower chambers of your heart don't work together as they should. When this happens, the lower chambers don't fill completely or pump enough blood to your lungs and body. This can make you feel tired, dizzy, or have palpitations or chest pain. Blood also collects in your heart, which increases the risk of blood clots forming and can lead to strokes or other complications. Atrial fibrillation can also occur without any signs or symptoms. Untreated fibrillation can lead to serious and even life-threatening complications.

Sometimes atrial fibrillation goes away on its own. For some people, atrial fibrillation is an ongoing heart problem that lasts for years. Over time, it can become more common and last longer. Treatment restores normal heart rhythm, helps control symptoms and prevents complications. Your doctor can recommend medications, medical procedures, and lifestyle changes to treat your atrial fibrillation.


The most common symptom of atrial fibrillation is fatigue. Other signs and symptoms include:

  • Palpitations
  • Difficulty breathing, especially when lying down
  • Chestpain
  • Low bloodpressure
  • Dizziness or fainting

Keep track of when and how often your symptoms occur, what you feel, and whether these things change over time. These are all important clues for your doctor.


Atrial fibrillation is treated with lifestyle changes, medications, and procedures, including surgery, to prevent blood clots, slow your heart rate, or restore your heart's normal rhythm.

Your doctor may also treat the underlying condition that the risk of atrial fibrillation increases , such as overweight or obesity , sleep apnea, or an overactive thyroid.

Lifestyle changes

Your doctor may recommend changing your lifestyle to a healthy lifestyle , such as:


Your doctor may consider treating your atrial fibrillation with medicines to slow your heart rate or make your heart rhythm more smooth:

  • Beta blockers, such as metoprolol, carvedilol and atenolol, to slow down the rate at which the lower chambers of the heart pump blood around the body. Speed ​​control is important because it gives the ventricles enough time to fill completely with blood. With this approach, the abnormal heart rhythm will continue, but you may feel better and have fewer symptoms. Beta-blockers are usually taken by mouth, but can be given through a tube in an emergency. If the dose is too high, the heart may beat too slowly. These drugs can also worsen COPD and arrhythmia.
  • Blood thinners to prevent blood clots and lower the risk of stroke . These drugs include edoxaban, dabigatran, warfarin, heparin, and clopidogrel. You may not need to use blood thinners if you are not at risk for a stroke. Blood thinning medicines can cause bleeding. Other side effects include indigestion and heart attack.
  • Calcium channel blockers to regulate the speed at which the lower chambers of the heart pump blood around the body. They include diltiazem and verapamil.
  • Digitalis, or digoxin , to regulate speed, the blood is pumped around the body. It should be used with caution as its use can lead to other arrhythmias.
  • Other heart rhythm medicines to slow down or change an abnormal heart rhythm to a normal, steady rhythm when a heart is beating too fast. Rhythm control is an approach recommended for people who continue to have symptoms or who are otherwise not getting better with speed control medications. Rhythm monitoring can also be used for people who have only recently started atrial fibrillation or for very physically active people and athletes. These drugs can be used alone or in combination with electrical cardioversion. Or your doctor can prescribe some of these medicines to use as needed if you feel symptoms of atrial fibrillation. Some heart rhythm medicines can make arrhythmias worse. Other side effects include effects on the liver, lungs and other organs, low blood pressure and indigestion.

Your doctor can recommend treatments for an underlying cause or to reduce atrial fibrillation risk factors . For example, he or she may prescribe medications to treat overweight and obesity, an overactive thyroid, lower high blood pressure, control high blood cholesterol, control or prevent diabetes, or to help you stop smoking.

Procedures or surgery

Your doctor may recommend a procedure, especially if lifestyle changes and medications alone haven't improved your symptoms. Usually, your doctor will only consider surgery to treat your atrial fibrillation if you are going to have surgery to treat another heart condition.

  • Catheter ablation to destroy the tissue causing the arrhythmia. Ablation is not always successful and in rare cases can lead to serious complications, such as a stroke. The risk of atrial fibrillation recurring is highest in the first weeks after the procedure. If this happens, your doctor can repeat the procedure. In some cases, your doctor will place a pacemaker during the procedure to make sure your heart beats correctly once the tissue causing the problems has been destroyed.
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