Atrial fibrillation or flutter is a common type of abnormal heartbeat. The heart rhythm is fast and irregular in this condition.
Auricular fibrillation; A-fib
When working well, the four chambers of the heart contract (squeeze) in an organized way.
The electrical signal that tells your heart to contract begins in an area called the sinoatrial node (also called the sinus node or SA node). These signals help your heart pump the right amount of blood for your body’s needs.
In atrial fibrillation, the electrical impulse of the heart is not regular.
Parts of the heart cannot contract in an organized pattern.
As a result, the heart cannot pump enough blood to meet the body's needs.
In atrial flutter, the ventricles (lower heart chambers) may beat very rapidly, but in a regular pattern.
These problems can affect both men and women. They become more common with increasing age.
Cardioversion treatment is used to get the heart back into a normal rhythm right away. There are two options for treatment:
Electric shocks to your heart
Drugs given through a vein
These treatments may be done as an emergency, or planned ahead of time.
Daily medicines taken by mouth are used to:
Slow the irregular heartbeat. These drugs may include beta-blockers, calcium channel blockers, and digoxin.
Prevent atrial fibrillation from coming back. These drugs work well in many people, but they can have serious side effects. Atrial fibrillation returns in many people, even while they are taking these medicines.
Blood thinners are medicines that are used to reduce the risk of developing a blood clot that travels in the body (such as a stroke). They include heparin, warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), and dabigatran (Pradaxa).
These drugs increase the chance of bleeding, so not everyone can use them. Antiplatelet drugs such as aspirin or clopidogrel may also be prescribed. Your doctor will consider your age and other medical problems when deciding which drugs are best.
A procedure called radiofrequency ablation can be used to destroy areas in your heart where the heart rhythm problems originate. You may need a heart pacemaker after this procedure.
Treatment can often control this disorder. Many people with atrial fibrillation do very well.
Atrial fibrillation tends to return and get worse. It may come back even with treatment.
Clots that break off and travel to the brain can cause a stroke.
When to Contact a Medical Professional
Call your health care provider if you have symptoms of atrial fibrillation or flutter.
Talk to your health care provider about steps to treat conditions that cause atrial fibrillation/flutter. Avoid binge drinking.
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Dobrev D, Nattel S. New antiarrhythmic drugs for treatment of atrial fibrillation. Lancet. 2010;375:1212-1223.
Morady F, Zipes DP. Atrial fibrillation: clinical features, mechanisms, and management. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 40.
Olgin J, Zipes DP. Specific arrhythmias: diagnosis and treatment. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 39.
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.