Atrial fibrillation or flutter

Auricular fibrillation; AFib; A-fib; Afib; Supraventricular arrhythmia; AF; AFL 

Atrial fibrillation (Afib) and atrial flutter are common types of abnormal heart rhythms (arrhythmias) which affect the upper chambers (atria) of the heart.

In atrial flutter, the heart beats too fast, but mostly continues to contract in a regular rhythm. AFib is a closely related condition in which the atria contract in a chaotic manner, or "quivers." This creates an irregular heart rhythm that is also usually too fast. Afib and atrial flutter often occur in the same person at different times.

Atrial fibrillation

A lot of things can make your heart beat faster, like kissing the person you love or watching a scary movie. But sometimes, your heart beats not only faster but also out of rhythm. That can be a problem if this continues over a long period of time and isn't treated. Let's talk about a condition called atrial fibrillation. If you can listen to your heart through a stethoscope, your heart beat should sound something like this, or lub dub, lub dub, lub dub. If you have atrial fibrillation, the top two chambers of your heart contract too quickly, and in an irregular pattern. So what you'd hear if you listened through a stethoscope would be more like this. Atrial fibrillation doesn't just sound funny, this irregular beat can prevent your heart from pumping enough blood out to the rest of your body. Age may cause atrial fibrillation. As you get older, it's more common to have an irregular heartbeat. You're also more likely to have atrial fibrillation if you've had another heart problem, like valve disease, coronary artery disease, or heart failure. Some people get atrial fibrillation because they drink too much alcohol or take certain medicines. To find out you may have atrial fibrillation. You'll feel your heart race and flutter-and not just once in a while, but often. You may also have trouble breathing and feel tired and dizzy. Your doctor can listen for fluttering while listening to your heart with a stethoscope. You may also need a test that records your heart's rhythms, like an ECG, which you have in your doctor's office, or a Holter monitor that you wear around for a day. Your doctor may also prescribe imaging tests to look at your heart and check whether its electrical system is working properly. If you do have atrial fibrillation, your doctor can give you medicine to slow your racing heart. Often, the next step is to restore the normal heart rhythm with an electric shock, a process called Cardioversion. However, if the atria haven't been contracting well for 48 hours or more, blood clots may have formed there. These patients are usually given anti-coagulant medicines before Cardioversion to prevent the clots from moving to the brain and causing a stroke when normal rhythm is restored. If Cardioversion doesn't solve the problem, a procedure called Cardiac ablation can be done to destroy the bad areas of your heart that are causing your heart to beat abnormally. Usually doctors can treat atrial fibrillation so that it becomes a minor nuisance, instead of a big problem. But, the condition can come back, even after it's been treated. If it continues, atrial fibrillation can lead to heart failure. To avoid complications from atrial fibrillation, call your doctor if you're feeling flutters in your chest, and they don't go away.

Heart - section through the middle

The interior of the heart is composed of valves, chambers, and associated vessels.

Heart - front view

The external structures of the heart include the ventricles, atria, arteries and veins. Arteries carry blood away from the heart while veins carry blood into the heart. The vessels colored blue indicate the transport of blood with relatively low content of oxygen and high content of carbon dioxide. The vessels colored red indicate the transport of blood with relatively high content of oxygen and low content of carbon dioxide.

Anterior heart arteries

The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.

Conduction system of the heart

The intrinsic conduction system sets the basic rhythm of the beating heart by generating impulses which stimulate the heart to contract.

Heartbeat

The heart has four chambers and four main blood vessels that either bring blood to the heart, or carry blood away. The four chambers are the right atrium and right ventricle and the left atrium and left ventricle. The blood vessels include the superior and inferior vena cava. These bring blood from the body to the right atrium. Next is the pulmonary artery that carries blood from the right ventricle to the lungs. The aorta is the body's largest artery. It carries oxygen-rich blood from the left ventricle to the rest of the body. Beneath the tough fibrous coating of the heart, you can see it beating. Inside the chambers are a series of one-way valves. These keep the blood flowing in one direction. Dye injected into the superior vena cava, will pass through all the heart's chambers during one cardiac cycle. Blood first enters the heart's right atrium. A muscle contraction forces the blood through the tricuspid valve into the right ventricle. When the right ventricle contracts, blood is forced through the pulmonary semilunar valve into the pulmonary artery. Then it travels to the lungs. In the lungs, the blood receives oxygen then leaves through the pulmonary veins. It returns to the heart and enters the left atrium. From there, blood is forced through the mitral valve into the left ventricle. This is the muscular pump that sends blood out to the rest of the body. When the left ventricle contracts, it forces blood through the aortic semilunar valve and into the aorta. The aorta and its branches carries the blood to all the body's tissues.

Atrial fibrillation overview

Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. It affects more than 2 million individuals in the United States, and as many as 160,000 new cases are diagnosed each year. The incidence of atrial fibrillation increases with age, and it is often associated with hypertension, valvular and pulmonary disease, metabolic disorders, and coronary artery disease. It is usually triggered by rapid firing from the pulmonary veins, followed by disorganized and asymmetrical impulse through the atria resulting in over 400 beats/min. The ventricles also respond in an irregular way. A serious consequence resulting from AF is clot formation in the atrium, especially when the atria have enlarged and have areas of pooling blood, which subsequently leads to embolism. Risk of thromboembolism is greater in people with diabetes, hypertension, history of embolism, diseases of the valves, and heart failure. In atrial flutter, regular atrial rates range from 250 to 350 beats/min. Most people with atrial flutter have some type of underlying heart problem such as hypertension, coronary artery disease, pericarditis, or valvular heart disease. It can also be caused by a congenital heart defect. Atrial flutter increases the patient’s risk of thromboembolism by 3% per year. Prevention and treatment of atrial flutter should be approached as described for atrial fibrillation. Long-term anticoagulation therapy is recommended for both conditions to reduce the risk of thromboembolism. Radiofrequency catheter ablation is very effective and has minimal risks. It can even be considered as an alternative to drug therapy.

Causes

Symptoms

Exams and Tests

Treatment

Outlook (Prognosis)

When to Contact a Medical Professional

Prevention