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February 3, 2012
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Atrial Fibrillation

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Atrial Fibrillation Overview

Atrial fibrillation describes an irregular and often rapid heart rhythm. The irregular rhythm, or arrhythmia, results from abnormal electrical impulses in the heart. The irregularity can be continuous, or it can come and go.

Normal heart contractions begin as an electrical impulse in the right atrium. This impulse comes from an area of the atrium called the sinoatrial (SA) or sinus node, the "natural pacemaker."

  • As the impulse travels through the atrium, it produces a wave of muscle contractions. This causes the atria to contract.

  • The impulse reaches the atrioventricular (AV) node in the muscle wall between the 2 ventricles. There, it pauses, giving blood from the atria time to enter the ventricles.

  • The impulse then continues into the ventricles, causing ventricular contraction that pushes the blood out of the heart, completing a single heartbeat.

In a person with a normal heart rate and rhythm the heart beats 50-100 times per minute.

  • If the heart beats more than 100 times per minute, the heart rate is considered fast (tachycardia).

  • If the heart beats less than 50 times per minute, the heart rate is considered slow (bradycardia).
In atrial fibrillation, multiple impulses travel through the atria at the same time.
  • Instead of a coordinated contraction, the atrial contractions are irregular, disorganized, chaotic, and very rapid. The atria may contract at a rate of 400-600 per minute.

  • These irregular impulses reach the AV node in rapid succession, but not all of them make it past the AV node. Therefore, the ventricles beat slower, often at rates of 110-180 beats per minute in an irregular rhythm.

  • The resulting rapid, irregular heartbeat causes an irregular pulse and sometimes a sensation of fluttering in the chest.
Atrial fibrillation can occur in several different patterns.
  • Intermittent (paroxysmal): The heart develops atrial fibrillation and typically converts back again spontaneously to normal (sinus) rhythm. The episodes may last anywhere from seconds to days.

  • Persistent: Atrial fibrillation occurs in episodes, but the arrhythmia does not convert back to sinus rhythm spontaneously. Medical treatment is required to end the episode.

  • Permanent: The heart is always in atrial fibrillation. Conversion back to sinus rhythm either is not possible or is deemed not appropriate for medical reasons.
Atrial fibrillation, often called A Fib, is a very common heart rhythm disorder.
  • It affects about 1% of the population, mostly people older than 50 years. This amounts to more than 2 million people.

  • The risk of developing atrial fibrillation increases as we get older. About 5% of people older than 80 years have atrial fibrillation.

For many people, atrial fibrillation may cause symptoms but does no harm.

  • Complications can arise, but appropriate treatment reduces these risks.

  • If treated properly, atrial fibrillation rarely causes serious or life-threatening problems.
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Atrial Fibrillation

Congestive Heart Failure Overview

The heart is a pump that works together with the lungs. It pumps blood in 2 ways.

  • It pumps blood from the heart to the lungs to pick up oxygen. The oxygenated blood returns to the heart.
  • It then pumps blood out into the circulatory system of blood vessels that carry blood through the body.

The heart consists of 4 chambers.

  • The upper chambers are called atria, and the lower chambers are called ventricles.
  • The right atrium and ventricle receive blood from the body through the veins and then pump the blood to the lungs.
  • The left atrium and ventricle receive blood back from the lungs and pump it out the aorta into the arteries, feeding all organs and tissues of the body.
  • Because the left ventricle has to pump blood through the entire body, it is a stronger pump than the right ventricle.

Heart failure sounds frightening becaus...

Read the Congestive Heart Failure article »


Read What Your Physician is Reading on Medscape

Atrial Fibrilation »

Atrial fibrillation (AF) is a supraventricular tachyarrhythmia characterized by disorganized atrial electrical activity and progressive deterioration of atrial electromechanical function.

Read More on Medscape Reference »

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