Atrial fibrillation

At a Glance

Atrial fibrillation (AF·AFib) is a common arrhythmia characterized by the disruption of coordination between the atria and ventricles, resulting in an irregular heartbeat.

Typical manifestations include palpitations, fatigue, dizziness, dyspnea, and chest pain; some individuals may experience syncope or hypotension.

How the disease works

It is associated with changes in cardiac tissue or electrical signals. Contributing factors may include hypertension, coronary artery disease, valvular heart disease, hyperthyroidism, and aging, although the cause remains unspecified in some cases.

When the electrical activity of the atria becomes irregular, the contraction of the atria and ventricles becomes uncoordinated, which can reduce the volume of blood entering the ventricles or being pumped out to the body.

Variations in presentation among individuals

Advanced age, family history, obesity, diabetes, heart failure, sleep apnea, chronic kidney disease, lung disease, smoking, and excessive alcohol consumption can increase the risk. Individual risks and symptoms vary.

The broad framework of diagnosis and management

Symptoms may be entirely absent or appear intermittently. The course varies from short paroxysms to persistent states; if untreated, the risk of complications such as thrombosis, stroke, and heart failure may increase.

Diagnosis is conducted by comprehensively integrating symptoms, medical history, family history, and physical examination with ECG, echocardiography, blood tests, and, if necessary, long-term ECG monitoring.

Current status of treatment

Since intermittent atrial fibrillation may not be captured during short examinations, symptoms and recurrence risk are not determined by a single test result alone, and differentiation from other tachyarrhythmias is required.

The broad framework of management consists of stroke risk assessment, heart rate or rhythm control, and the management of comorbidities and lifestyle risk factors.

Current treatments may include anti-thrombotic medication, heart rate/rhythm control medication, electrical cardioversion, catheter ablation, and surgical approaches in certain situations.

How to read clinical trials

In follow-up, symptoms, ECG changes, and the benefits and side effects of treatment must be evaluated together; the Dutch-GERAF study in this packet is merely a registration record of an observational study and does not demonstrate efficacy, approval, or standard of care.

Points to verify during clinical consultations

In clinical practice, one can assess the onset and frequency of symptoms, presence of syncope, chest pain, or dyspnea, current medications and bleeding risk, comorbidities such as hypertension, diabetes, and heart failure, as well as family history and alcohol/smoking consumption.