Understanding Atrial Fibrillation
Atrial fibrillation is common, treatable, and highly individualized. The major decisions usually involve symptoms, stroke prevention, and rhythm or rate control.
What is atrial fibrillation?
Atrial fibrillation, or AF, is an irregular rhythm that begins in the upper chambers of the heart. Some people feel a rapid or irregular heartbeat; others notice fatigue, shortness of breath, reduced exercise tolerance, dizziness, or no symptoms at all.
Why stroke risk matters
AF can allow blood to stagnate in the atria, increasing the risk of clot formation and stroke in some patients. Whether anticoagulation is appropriate depends on individual risk factors and must be balanced against bleeding risk.
Rate control and rhythm control
Rate-control strategies aim to keep the ventricular rate in a reasonable range. Rhythm-control strategies aim to restore and maintain normal rhythm using medication, cardioversion, or procedures such as catheter ablation. The right strategy depends on symptoms, duration of AF, underlying heart disease, age, preferences, and other clinical factors.
Monitoring
Electrocardiograms, ambulatory monitors, wearable devices, and implanted devices can all provide useful rhythm information in the right setting. Data should be interpreted in context rather than treated as a diagnosis in isolation.