Skip Navigation

Atrial Fibrillation

About Atrial Fibrillation

atrial fibrillationInformation provided by the team at the Geisinger Atrial Fibrillation Center

What is atrial fibrillation?
Atrial fibrillation (Afib) is the most common heart rhythm problem. It occurs when the electrical signals in the upper chambers of the heart (left and right atria) do not work in synchrony with the lower chambers of the heart (left and right ventricles). The electrical signals fire chaotically, and the heart beats irregularly. Afib can cause a normal resting rate of 60 to 100 beats-per-minute in the upper chambers to increase to 300 to 600 beats-per-minute. This can cause the lower chambers (ventricles) to beat at rates of 100 to 200 beats-per-minute. These irregular heart beats cause anxiety, discomfort and increase the risk of stroke and other cardiovascular problems. Though initially an electrical problem, over time if uncorrected these rapid heart rates can weaken the hearts’ mechanical pumping efficiency.

What are the risk factors of atrial fibrillation?
Increasing age: the incidence of atrial fibrillation increases with age. In the fifth decade the incidence of atrial fibrillation is about 1%, progressing to more than 12% of people over 80 years old.

  • High blood pressure
  • Diabetes
  • Coronary artery disease
  • Recent open heart surgery
  • Valvular heart disease (eg mitral regurgitation)
  • Hyperthyroidism
  • Chronic lung disease (COPD)
  • Pulmonary embolism
  • Certain congenital heart problems
  • Sleep apnea
  • Lifestyle choices such as excessive alcohol or caffeine intake, use of over the counter decongestants, or cocaine

Though most people with atrial fibrillation will have one or more of the above risk factors, a small percentage of patients have atrial fibrillation in absence of an apparent cause.

Are there different types of atrial fibrillation?
Heart rhythm experts have classified three distinct patterns of atrial fibrillation:

  • Paroxsymal atrial fibrillation are short lived episodes, by definition less than 1 week in duration, which spontaneously return to normal rhythm.
  • Persistent atrial fibrillation defines prolonged arrhythmia episodes that require medications or procedures to restore normal rhythm.
  • Permanent defines patients in chronic atrial fibrillation

Heart monitoring studies have demonstrated that 90% of atrial fibrillation patients will have recurrent episodes that tend to increase over time. Many of these people will be unaware of these episodes, some lasting longer than 48 hours.

What are the dangers of atrial fibrillation?

Though historically atrial fibrillation was thought to be a benign condition, we now know that atrial fibrillation poses significant long term health risks, as well as potential to compromise quality of life. Additionally, chronic atrial fibrillation adversely impacts long term prognosis compared to people without this arrhythmia. 

As the atria effectively  function as the heart’s ‘booster pumps’, the loss of synchronized atrial contraction can compromise the heart’s pumping efficiency by as much as 25%. The resulting physical impact extends a broad spectrum from mild reduction in exercise tolerance to outright heart failure, with imaging evidence of an enlarged weakened heart.

Afib permits blood to stagnate in the atria with risk for clot formation, greatest in a small pocket of the left atrium called the appendage. If the clot is dislodged, it becomes mobile within the body’s blood vessels. Though a clot can travel to any body organ, the most feared complication is a stroke, resulting from obstruction of a blood vessel within the brain. Patients with atrial fibrillation are two to seven times more likely to have a stroke than the general population.  Statistically, 15% of strokes occurring in the United States are the result of atrial fibrillation.

These risks mandate an aggressive, informed strategy to manage atrial fibrillation. Your electrophysiologist will examine your individual risk and partner with you to implement a treatment plan to minimize your risks.

What are the symptoms of atrial fibrillation?
Common symptoms that may indicate Afib include:

  • Irregular and rapid heartbeat
  • Heart palpitations or rapid thumping inside the chest
  • Dizziness, sweating and chest pain or pressure
  • Shortness of breath, anxiety
  • Tiring more easily when exercising
  • Fainting (also known as syncope)