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Atrial Fibrillation (cont.)

Ongoing Concerns

Atrial fibrillation with heart disease

Heart disease—including high blood pressure, heart valve disease, and coronary artery disease—is the most common cause of atrial fibrillation. Seen mostly in people older than 65, this type of atrial fibrillation is often the most complicated to manage.

At first, people usually have paroxysmal atrial fibrillation. Paroxysmal episodes go away on their own. They may last anywhere from a few seconds to a few weeks and may not cause symptoms.

Paroxysmal atrial fibrillation episodes may recur for weeks or years, although usually the disease progresses, and atrial fibrillation becomes persistent, meaning that it no longer goes away on its own. Your doctor may try a procedure called cardioversion, using either medicine or low-voltage electrical shock (electrical cardioversion), to return the irregular heartbeat to a normal rhythm (normal sinus rhythm). The decision to try cardioversion is based upon how bothersome you find the symptoms and how long the episode of atrial fibrillation has persisted.

If the heart cannot be converted to a normal rhythm or does not stay in a normal rhythm, medicines are used to control the heart rate and prevent it from becoming dangerously fast. Many people are able to live full and active lives while being treated for atrial fibrillation. Others may need further treatment because they develop shortness of breath, weakness, fainting, or other significant symptoms.

If atrial fibrillation is not treated, it can further damage the heart and cause serious complications, such as heart failure.

You can lower your risk of complications by controlling high blood pressure.

Lone atrial fibrillation

In rare cases, doctors cannot find the cause of atrial fibrillation. These cases are called lone atrial fibrillation. Lone atrial fibrillation occurs more often in people younger than 65. It often stops on its own, or it may need to be treated.

Treatment may be needed if a rapid heartbeat causes discomfort, decreased energy, or other unacceptable symptoms.

Stroke risk

Atrial fibrillation increases your chance of having a stroke. When blood does not completely empty out of the rapidly beating atria, a clot can develop in the blood that pools in the atria. The clot may travel from the heart to the brain, causing a stroke.

The risk of stroke increases with age and with high blood pressure, diabetes, heart valve disease, heart failure, or a previous stroke or transient ischemic attack (TIA). You can lower your risk of stroke by taking medicines that help prevent blood clots, such as warfarin or aspirin.

If you are age 55 or older and have atrial fibrillation, you can find your risk of having a stroke in the next 5 years using this Interactive Tool: Are You at Risk for a Stroke if You Have Atrial Fibrillation?Click here to see an interactive tool.

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