Atrial fibrillation

High blood pressure and valvular heart disease are the most common alterable risk factors for AF. Cardiovascular factors known to be associated with the development of AF include high blood pressure, coronary artery disease, mitral valve stenosis (e.g., due to rheumatic heart disease or mitral valve prolapse), mitral regurgitation, left atrial enlargement, hypertrophic cardiomyopathy (HCM), pericarditis, congenital heart disease, and previous heart surgery.

Long-term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia.

It is a type of supraventricular tachycardia.

There are four main types: atrial fibrillation, paroxysmal supraventricular tachycardia (PSVT), atrial flutter, and Wolff–Parkinson–White syndrome.

A diagnosis is made by feeling the pulse and may be confirmed using an electrocardiogram (ECG).

Changes in the normal ECG pattern occur in numerous cardiac abnormalities, including cardiac rhythm disturbances (such as atrial fibrillation and ventricular tachycardia), inadequate coronary artery blood flow (such as myocardial ischemia and myocardial infarction), and electrolyte disturbances (such as hypokalemia and hyperkalemia).

Atrial fibrillation (AF or A-fib) is an abnormal heart rhythm characterized by rapid and irregular beating of the atrial chambers of the heart.

There are two major classes of cardiac fibrillation: atrial fibrillation and ventricular fibrillation.

Occasionally there may be heart palpitations, fainting, lightheadedness, shortness of breath, or chest pain. Rapid and irregular heart rates may be perceived as the sensation of the heart beating too fast, irregularly, or skipping beats (palpitations) or exercise intolerance and occasionally may produce anginal chest pain (if the high heart rate causes the heart's demand for oxygen to increase beyond the supply of available oxygen (ischemia)).

Three common descriptions of palpitation are "flip-flopping" (or "stop and start"), often caused by premature contraction of the atrium or ventricle, with the perceived "stop" from the pause following the contraction, and the "start" from the subsequent forceful contraction; rapid "fluttering in the chest", with regular "fluttering" suggesting supraventricular or ventricular arrhythmias (including sinus tachycardia) and irregular "fluttering" suggesting atrial fibrillation, atrial flutter, or tachycardia with variable block; and "pounding in the neck" or neck pulsations, often due to cannon A waves in the jugular venous, pulsations that occur when the right atrium contracts against a closed tricuspid valve.

Anti-clotting medications include warfarin and direct oral anticoagulants.

It is commonly used to treat blood clots such as deep vein thrombosis and pulmonary embolism and to prevent stroke in people who have atrial fibrillation, valvular heart disease or artificial heart valves.

The disease is associated with an increased risk of heart failure, dementia, and stroke.

People with vascular dementia tend to have risk factors for disease of the blood vessels, such as tobacco use, high blood pressure, atrial fibrillation, high cholesterol or diabetes, or other signs of vascular disease such as a previous heart attack or angina.

Presentation is similar to other forms of rapid heart rate and may be asymptomatic.

Atrial fibrillation is one of the most common cardiac arrhythmias.

Lung-related risk factors include COPD, obesity, and sleep apnea.

A diagnosis is made by feeling the pulse and may be confirmed using an electrocardiogram (ECG).

It may be present in case of premature beats or atrial fibrillation.

A-fib and atrial flutter resulted in 193,300 deaths in 2015, up from 29,000 in 1990.

It is typically not a stable rhythm, and often degenerates into atrial fibrillation (AF).

In the developing world valvular heart disease often occurs as a result of rheumatic fever. Cardiovascular factors known to be associated with the development of AF include high blood pressure, coronary artery disease, mitral valve stenosis (e.g., due to rheumatic heart disease or mitral valve prolapse), mitral regurgitation, left atrial enlargement, hypertrophic cardiomyopathy (HCM), pericarditis, congenital heart disease, and previous heart surgery.

The damaged valves may result in heart failure, atrial fibrillation and infection of the valves.

The abnormal heart rhythm (arrhythmia) is sometimes only identified with the onset of a stroke or a transient ischemic attack (TIA).

The most common underlying pathology leading to TIA and stroke is a cardiac condition called atrial fibrillation, where poor coordination of contraction leads to a formation of a clot in the atrial chamber that can become dislodged and travel to a cerebral artery.

High blood pressure and valvular heart disease are the most common alterable risk factors for AF.

Since most cases of AF are secondary to other medical problems, the presence of chest pain or angina, signs and symptoms of hyperthyroidism (an overactive thyroid gland) such as weight loss and diarrhea, and symptoms suggestive of lung disease can indicate an underlying cause.

Cardiovascular factors known to be associated with the development of AF include high blood pressure, coronary artery disease, mitral valve stenosis (e.g., due to rheumatic heart disease or mitral valve prolapse), mitral regurgitation, left atrial enlargement, hypertrophic cardiomyopathy (HCM), pericarditis, congenital heart disease, and previous heart surgery.

Also there may be development of an irregular heart rhythm known as atrial fibrillation.

Rapid and irregular heart rates may be perceived as the sensation of the heart beating too fast, irregularly, or skipping beats (palpitations) or exercise intolerance and occasionally may produce anginal chest pain (if the high heart rate causes the heart's demand for oxygen to increase beyond the supply of available oxygen (ischemia)).

Other causes are heart conditions including myocardial infarction, mitral valve disease, chronic atrial fibrillation, cardiomyopathies, and prosthesis, in all of which thrombi are prone to develop.

A typical ECG in AF shows no P waves and an irregular ventricular rate.

If the baseline has a totally irregular form, this suggests fibrillatory waves of atrial fibrillation or possibly artefact; a saw tooth shaped baseline suggests the flutter waves of atrial flutter.

Often it starts as brief periods of abnormal beating which become longer and possibly constant over time.

Atrial kick is absent or disrupted if there is loss of normal electrical conduction in the heart, such as caused by atrial fibrillation, atrial flutter, or heart block.

Occasionally there may be heart palpitations, fainting, lightheadedness, shortness of breath, or chest pain.

A number of factors make a heart related cause more likely including age over 35, prior atrial fibrillation, and turning blue during the event.

Since most cases of AF are secondary to other medical problems, the presence of chest pain or angina, signs and symptoms of hyperthyroidism (an overactive thyroid gland) such as weight loss and diarrhea, and symptoms suggestive of lung disease can indicate an underlying cause. Other factors include excess alcohol intake, tobacco smoking, diabetes mellitus, and thyrotoxicosis.

In addition, those with hyperthyroidism may present with a variety of physical symptoms such as palpitations and abnormal heart rhythms (the notable ones being atrial fibrillation), shortness of breath (dyspnea), loss of libido, amenorrhea, nausea, vomiting, diarrhea, gynecomastia and feminization.

They may take relatively benign forms such as atrial fibrillation, leading to symptoms of palpitations, breathlessness, or fatigue.

Cardiovascular factors known to be associated with the development of AF include high blood pressure, coronary artery disease, mitral valve stenosis (e.g., due to rheumatic heart disease or mitral valve prolapse), mitral regurgitation, left atrial enlargement, hypertrophic cardiomyopathy (HCM), pericarditis, congenital heart disease, and previous heart surgery.

Atrial fibrillation is a common complication of resulting left atrial enlargement, which can lead to systemic thromboembolic complications like stroke.

Cardiovascular factors known to be associated with the development of AF include high blood pressure, coronary artery disease, mitral valve stenosis (e.g., due to rheumatic heart disease or mitral valve prolapse), mitral regurgitation, left atrial enlargement, hypertrophic cardiomyopathy (HCM), pericarditis, congenital heart disease, and previous heart surgery.

However, if atrial fibrillation is present, a P wave would not be present.

Examination of the jugular veins may reveal elevated pressure (jugular venous distention).

The absence of 'a' waves may be seen in atrial fibrillation.