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Atrial fibrillation — is a heart rhythm disorder in which the atria contract chaotically, and the heart rhythm becomes irregular and often accelerated. Because of this, normal blood circulation may be impaired and the risk of blood clot formation may increase. The disease may manifest as interruptions in the work of the heart, a rapid pulse, weakness, shortness of breath or dizziness, but sometimes it proceeds almost asymptomatically.
A rhythm disorder does not always indicate a critical condition, but it should not be left without attention. Even short episodes of interruptions in the work of the heart can affect well-being and increase the risk of complications. At the Oxford Medical clinic, patients can receive a consultation with a cardiologist, undergo ECG, 24-hour Holter monitoring, heart ultrasound and other examinations to clarify the diagnosis and select treatment.
The medical name of this disorder is atrial fibrillation. Normally, the heart contracts rhythmically: an electrical impulse arises in the sinus node, passes through the atria and ventricles and ensures their sequential work. In atrial fibrillation, electrical signals in the atria become chaotic, because of which the coordination of heart contractions is disrupted.
As a result, the pulse becomes irregular, and the heart rate may change — from moderate to significantly accelerated. In some patients, arrhythmia is accompanied by pronounced discomfort, in others — it may be almost unfelt for a long time. That is why it is impossible to confirm the diagnosis only by symptoms: ECG and other examination methods are needed for this.
Atrial fibrillation may occur periodically in the form of attacks or persist for a long time. The course of the disease and the frequency of episodes in different patients may differ significantly, therefore the treatment tactics are always selected individually.
In cardiology, several clinical variants of the course of the disease are distinguished. The main forms of atrial fibrillation differ in the duration of episodes, the frequency of attacks and, accordingly, the approach to treatment.
| Form | Features of the course | What is important for the patient to know |
| Paroxysmal | Attacks occur periodically and usually pass independently within 7 days | Episodes may recur, therefore control and observation by a cardiologist are important |
| Persistent | The rhythm disorder lasts more than 7 days and usually does not pass independently | Drug treatment or cardioversion may be needed to restore the rhythm |
| Long-standing persistent | Arrhythmia persists for more than 12 months | The treatment tactics are selected individually, taking into account symptoms and concomitant diseases |
| Permanent | Sinus rhythm cannot be restored | The main attention is paid to pulse control and prevention of complications |
Specialists of «Oxford Medical» explain that different forms of atrial fibrillation can affect well-being differently and have a different risk of complications. That is why it is important to take into account not only the very fact of rhythm disorder, but also the duration of attacks, the frequency of their occurrence, concomitant diseases and the risk of blood clot formation. This helps to select the most effective treatment tactics and determine whether drugs are needed to control rhythm, pulse or prevent stroke.
Atrial fibrillation rarely occurs without prerequisites. Most often, it is associated with changes in the work of the heart, vessels or other diseases that affect the heart rhythm. Sometimes an attack can be provoked by infection, severe stress, intoxication, surgery or a sharp increase in arterial pressure. In other cases, a rhythm disorder forms gradually against the background of chronic diseases.
Possible causes and risk factors include:
arterial hypertension, especially if the pressure remains elevated for a long time;
ischemic heart disease and previous myocardial infarction;
heart failure, cardiomyopathies, defects of the heart valves;
diseases of the thyroid gland, in particular thyrotoxicosis;
diabetes mellitus, obesity, metabolic disorders;
sleep apnea, chronic lung diseases;
excessive consumption of alcohol, stimulants, some medicinal products;
hereditary predisposition to rhythm disorders.
According to European Society of Cardiology (ESC), control of arterial pressure, body weight, glucose level, treatment of sleep apnea and other concomitant diseases helps reduce the frequency of atrial fibrillation attacks and the risk of cardiovascular complications.
Manifestations of atrial fibrillation can be different: from a pronounced attack with a sensation
of strong heartbeat to an almost asymptomatic course.
The most common symptoms:
irregular or accelerated pulse, sensation of interruptions in the work of the heart;
weakness, rapid fatigability during physical exertion;
shortness of breath, sensation of lack of air, discomfort in the chest;
dizziness, anxiety or a pre-fainting state.
Doctors of «Oxford Medical» note: the severity of symptoms does not always correspond to the severity of the rhythm disorder. In some patients, atrial fibrillation causes significant discomfort, while in others it may proceed almost unnoticed for a long time and be detected accidentally during ECG.
The main method of confirming the diagnosis is electrocardiography (ECG). It allows recording an irregular heart rhythm and characteristic changes inherent in atrial fibrillation. If the episode of rhythm disorder is short-term and is not captured on a standard ECG, the doctor may recommend 24-hour monitoring.
The main diagnostic methods:
electrocardiography (ECG);
Holter ECG monitoring for 24–48 hours;
heart ultrasound to assess the heart chambers, valves and contractile function;
blood tests to assess the level of electrolytes, glucose, thyroid gland function and other indicators.
During the examination, it is important not only to assess what the rhythm is in atrial fibrillation, but also to determine the frequency of attacks, the heart rate, the presence of concomitant rhythm disorders and possible complications. This helps the doctor select the optimal treatment tactics and determine the need for further observation.
According to the recommendations of European Society of Cardiology (ESC), it is important for patients with suspected atrial fibrillation to undergo a full examination even in those cases when symptoms occur periodically or pass quickly.
In atrial fibrillation, treatment depends on the form of arrhythmia, the duration of attacks, the heart rate, the patient’s age, the presence of concomitant diseases and the risk of thromboembolic complications. For each patient, the treatment scheme is selected individually after examination.
The main methods of treatment:
drug therapy to control the heart rate or maintain the normal rhythm of the heart;
electrical cardioversion — a procedure for restoring sinus rhythm with the help of a controlled electrical impulse (may be used in a prolonged attack or ineffectiveness of drug treatment);
anticoagulant therapy to reduce the risk of blood clot formation and stroke;
catheter ablation — a minimally invasive procedure during which, with the help of a special catheter, areas of the heart that provoke incorrect electrical impulses and rhythm disorder are affected (may be recommended in frequent attacks or insufficient effectiveness of drug therapy).
It is also important to control concomitant diseases and risk factors, in particular arterial hypertension, diabetes mellitus, obesity, sleep apnea and disorders of thyroid gland function. This helps reduce the frequency of repeated attacks and the risk of complications.
Doctors of «Oxford Medical» recommend not engaging in self-treatment in cases of heart rhythm disorders. Antiarrhythmic drugs and anticoagulants have clear indications and are selected individually after examination, since incorrect intake of such medicinal products can be dangerous.
The main danger of atrial fibrillation is associated with an increased risk of blood clot formation. Because of chaotic contractions of the atria, blood may stagnate, and this creates conditions for the formation of blood clots, which with the blood flow can enter the vessels of the brain and cause a stroke.
Possible complications:
ischemic stroke or transient ischemic attack;
heart failure or worsening of its course;
decreased tolerance of physical exertion, weakness and shortness of breath;
worsening of the course of cardiovascular diseases, in particular ischemic heart disease.
In some patients, against the background of rhythm disorder, myocardial ischemia may intensify, especially in the presence of narrowing of the coronary vessels. This may manifest as discomfort or pain in the chest, shortness of breath, weakness or worsening of well-being during physical exertion.
According to American Heart Association (AHA), atrial fibrillation increases the risk of stroke, heart failure and other cardiovascular complications, therefore timely diagnosis and treatment are of great importance.
It is impossible to completely exclude the risk of developing atrial fibrillation, but it is possible to reduce the probability of attacks and the risk of complications. It is especially important to control risk factors for people with arterial hypertension, excess weight, diabetes mellitus, diseases of the thyroid gland and other cardiovascular diseases.
For prevention, it is recommended to:
control arterial pressure and blood glucose level;
maintain normal body weight and a sufficient level of physical activity;
limit alcohol consumption and other harmful habits;
timely treat diseases of the heart, vessels and disorders of thyroid gland function.
Regular moderate physical activity, full sleep and control of chronic diseases help reduce the risk of repeated attacks.
The price of treatment of atrial fibrillation depends on the form of rhythm disorder, the necessary scope of examinations and the selected treatment tactics. In some cases, a consultation with a cardiologist, ECG and drug therapy are sufficient, in others Holter monitoring, heart ultrasound and other examinations or treatment procedures may be needed.
You can preliminarily get acquainted with the prices for medical services here. The doctor will orient you in more detail regarding diagnostics, the treatment program and the cost of services during the consultation. To make an appointment, contact the contact center by the phone number indicated on the website or use the online appointment form on the website.
The information is for informational purposes and does not replace a doctor's consultation.
Sources:
Atrial fibrillation increases the risk of blood clot formation, stroke, heart failure and worsening of tolerance to physical exertion. Patients with arterial hypertension, diabetes mellitus, a previous stroke or other cardiovascular diseases should be especially attentive.
The prognosis depends on the condition of the cardiovascular system, the presence of concomitant diseases, control of arterial pressure, the patient's age and regularity of treatment. Provided that therapy is correctly selected and there is observation by a cardiologist, many patients can lead an active lifestyle for many years.
The rhythm may be restored with medication, with the help of electrical cardioversion or catheter ablation. The method is chosen taking into account the duration of the attack, symptoms, the condition of the heart, the risk of thrombosis and concomitant diseases. Antiarrhythmic drugs must not be taken independently.
The pulse in atrial fibrillation is usually irregular and often accelerated, sometimes more than 100 beats per minute at rest. At the same time, in some patients the heart rate may remain moderate or be reduced. ECG helps to accurately assess the rhythm disorder.
A person may feel interruptions in the work of the heart, an irregular or accelerated pulse, weakness, shortness of breath, dizziness, discomfort in the chest or rapid fatigue. Sometimes symptoms are almost absent, therefore the rhythm disorder is detected only during ECG or Holter monitoring.
In many patients, moderate coffee consumption does not provoke attacks, but the reaction to caffeine is individual. If after coffee an accelerated pulse, anxiety or worsening of well-being appear, it is better to limit it and discuss this with a cardiologist.
By sensations, this is not always possible. Usually, extrasystolic arrhythmia is perceived as separate «pushes», pauses or isolated interruptions in the work of the heart, and atrial fibrillation — as an irregular, chaotic rhythm. ECG or Holter monitoring shows the exact difference.
Moderate physical activity is often allowed and may be useful, but the level of load must be determined by a doctor. It is important to take into account the form of arrhythmia, the frequency of attacks, pulse, pressure and the condition of the heart. In case of chest pain, severe shortness of breath or dizziness, training must be stopped.
Experienced doctors. The appointment is conducted by specialists with many years of experience who work according to modern protocols.
Accurate diagnosis. ECG, Holter monitoring, and cardiac ultrasound on expert-grade equipment help determine the type of arrhythmia.
Individual approach. The treatment plan is formed taking into account the symptoms, concomitant diseases, and the patient’s lifestyle.
Comfortable conditions. The doctor's appointment takes place at a convenient time, without queues, with attention to the patient's condition and needs.
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