Atrial fibrillation (also called AF or A Fib) is the most common form of arrhythmia (heart rhythm disorder). It affects many people,
including an estimated 2.3 million people in the United States. Atrial fibrillation
is more common in older people, people with high blood pressure, and people
with other kinds of heart disease. It can lead to serious health problems
such as stroke, fatigue, and heart failure. The August 27, 2003, issue of JAMA includes an article about atrial fibrillation.
Atrial fibrillation occurs when the electrical impulses that cause the
heart to beat in a regular rhythmic manner become disorganized, causing the
heart to beat irregularly and often too fast with too little force. The irregular
pulse can be felt and can be seen on an electrocardiogram. An electrocardiogram (ECG or EKG) is a recording of the electrical activity of the heart made from electrodes (electrical conductors) placed on the surface
of the skin, usually on each arm and leg and across the chest. On a normal
ECG, the electrical activity of the heart appears as regular peaks and valleys.
On an ECG of a person with atrial fibrillation, the peaks and valleys are
not regular and often are closer together, representing a quicker heartbeat.
Atrial fibrillation decreases the efficiency of the pumping action of the
heart. It also increases the risk of formation of blood clots inside the heart.
These blood clots can break off and go to other parts of the body, including
the brain where they can cause a stroke.
Some people with atrial fibrillation may not experience any symptoms
at all. Others report feeling palpitations (a sensation
of the heart "flopping") or may have chest discomfort or dizziness. A few
people develop sudden and severe shortness of breath.
The two most important treatment goals involve slowing the heart rate
to improve heart pumping efficiency and using anticoagulants (blood thinners) to prevent stroke.
Beta-Blockers and calcium blockers are types of medication that can slow the heart rate.
Warfarin and aspirin are blood thinners. Warfarin is more effective
in preventing strokes but can lead to bleeding and requires careful medical
Electrical cardioversion is a procedure
that can reestablish regular rhythm for patients with severe symptoms. The
patient is sedated and an electrical charge is given to the heart through
Other procedures involving surgery or use of a catheter (a tube inserted into the heart through a blood vessel) are
available for individuals with severe symptoms.
American Heart Association800/AHA-USA-1 (242-8721)http://www.americanheart.org
National Heart, Lung, and Blood Institute 301/592-8573http://www.nhlbi.nih.gov
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. A Patient Page on electrocardiograms was published in the April 23,
Sources: American College of Cardiology; National Heart, Lung, and Blood
Institute; American Heart Association
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Topic: HEART DISEASE
Parmet S, Lynm C, Glass RM. Atrial Fibrillation. JAMA. 2003;290(8):1118. doi:10.1001/jama.290.8.997