What is Atrial Fibrillation?

Atrial Fibrillation is a cardiac arrhythmia, the most common one. It occurs when the electrical stimulation that develops in the atria breaks up into hundreds of impulses per minute. As a result, the atria's activation is chaotic and their contraction is disorganized. This irregular contraction of the atria does not permit the heart to work to its full potential: in short, the blood is not pumped efficiently and staunches in the upper cardiac chambers. Furthermore, some of the impulses generated in the atria are transmitted to the ventricles at variable intervals, causing an increase of the heart rate and irregular ventricular contractions, causing the sensation we call "palpitations".

Who suffers from it?

Atrial fibrillation is an arrhythmia typical of elderly people. According to epidemiological researches, the prevalence of this arrhythmia progressively increases with age. It ranges between 0.5% in the 50-59 years decade and 8.8% in the 80-89 years decade. It follows that the incidence of Atrial Fibrillation increases with age. The average age of patients suffering from this arrhythmia is 75. Given the same age, men are more likely than women to suffer from Atrial Fibrillation.

What are the symptoms?

Palpitations, namely the sensation of an accelerated and irregular heartbeat. are the main symptom of Atrial Fibrillation. Other symptoms include dyspnea - the shortness of breath during physical efforts; dizziness, or light-headedness; syncope, or fainting; fatigue, or physical tiredness; and angina, causing retrosternal chest pain and discomfort.

What are the complications?

The main risk of complication with atrial fibrillation is a stroke: when the heart is in fibrillation, the atria no longer contract regularly, the blood tends to staunch in the upper cardiac chambers, and thrombi are formed - in other words, clots that can easily come off from where they are deposited. By travelling through the blood, these clots can reach the brain and obstruct a cerebral vein, causing a stroke. Other Atrial Fibrillation-related risks include heart failure, higher mortality rate and dementia.

What can I do?

You have to learn to listen to your body and check your pulse. Being aware of your heartbeat is extremely important: it could reveal abnormalities in the heart rate or rhythm, as a signal of Atrial Fibrillation. We can control our heart rhythm by checking the radial pulse.
It is highly advisable to consult a doctor when the heart rate is much higher or much lower than usual, or when you notice that the intensity of the pulsation is not even and that the interval between pulsations continuously changes.

What about the therapies?

In case of Atrial Fibrillation, there are various options that can help to solve or manage the problem. First of all, your doctor will choose one among two therapeutical strategies; rhythm control or rate control.

The rhythm control strategy aims at bringing the patient's sinus rhythm back to normal. This can be done in two ways: through cardioversion, allowing the interruption of the arrhythmia, or through medical therapies aiming at the prevention of the arrhythmias' recurrences. The rate control strategy is considered when the patient, despite attempts at cardioversion, still suffers from Atrial Fibrillation. In this case, the ventricular contraction's rate has to be reduced, to avoid palpitations and the risk of heart failure.

The treatment strategies described above should be supported by an anti-thrombotic therapy.A thrombus is a blood clot that can potentially cause a stroke. To prevent its formation, patients are treated with anti-platelet or oral anticoagulant drugs.

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