What is atrial fibrillation?

Atrial fibrillation is a form of irregular heart rate, or arrhythmia. Atrial fibrillation occurs when one or both of the upper chambers of the heart (the atria) quiver or 'fibrillate' rather than beat normally.

It is important to diagnose and treat atrial fibrillation to help prevent serious complications such as stroke and heart failure.

If managed correctly, people with atrial fibrillation can lead a long and active life.

What are the symptoms of atrial fibrillation?

Some people with atrial fibrillation have no symptoms. Others may have:

• heart palpitations or 'fluttering' heartbeat
• an irregular pulse
• dizziness or fainting spells
• weakness or tiredness

If you have chest pain that lasts for more than a few minutes, or any other heart attack warning signs, call triple zero (000) immediately and ask for an ambulance.

Atrial fibrillation can occur as a one-off episode, or can come and go, or can persist.

If you have symptoms that may be atrial fibrillation, it is important to see your doctor because it can have serious consequences. Atrial fibrillation reduces the heart's ability to pump blood properly. This increases the chance of a blood clot forming in the heart and travelling to the brain, where it can cause a stroke.

What causes atrial fibrillation?

The most common causes of atrial fibrillation are:

• long-term high blood pressure
• coronary heart disease
• heart valve disease

A less common cause is hyperthyroidism (an overactive thyroid gland).

Some factors may increase the risk of atrial fibrillation. These include:

• increasing age
• chest trauma or surgery
• drinking alcohol
• obesity
• family history of atrial fibrillation
• other medical conditions, such as infections, obstructive sleep apnoea, metabolic syndrome, diabetes, chronic kidney disease and lung disease

How is atrial fibrillation diagnosed?

Atrial fibrillation is usually diagnosed using an electrocardiogram, or ECG. If you have atrial fibrillation, your doctor will talk to you and examine you, and may order other tests such as a 24-hour heart monitor (called a holter monitor) or an echocardiogram (heart ultrasound).

How is atrial fibrillation treated?

Treatment will depend on your symptoms, the underlying cause and other health conditions you may have.

Atrial fibrillation can usually be well managed. Treatments include:

• Medication: to normalise the heart's rhythm or slow the heart rate. Some people with atrial fibrillation are advised to take medicines to reduce the risk of clotting to prevent stroke.
• Electrical cardioversion: An electrical shock is delivered to the heart to reset the heart's normal rhythm. The procedure is done under general anaesthetic.
• Pharmacological cardioversion: Medication is used to restore the heart's normal electrical rhythm.
• Catheter ablation: A procedure that uses energy to destroy (ablate) the area inside the heart that is causing the abnormal rhythm.
• Pacemaker: A small implantable device that stimulates the heart to maintain a regular heart rhythm.

Long-term management of atrial fibrillation

Most people are able to manage their atrial fibrillation and lead a relatively normal life. To look after your heart, it is important to take medications as prescribed, look after your general health, and visit your doctor regularly.

It is also important to live a healthy lifestyle to reduce the impact of atrial fibrillation on your life, by:

• eating healthily
• staying physically active — talk to your doctor about the right amount of exercise for you
• maintaining a healthy weight
• not smoking
• limiting or avoiding alcohol and caffeine
• managing diabetes, if you have it

The Heart Foundation has more information about lifestyle changes to manage atrial fibrillation