Middle aged woman, discover what is AF

What is AF?

What is atrial fibrillation (AF)?

The heart has an electrical system that controls the rate and rhythm of your heartbeat. In a healthy heart, the electrical signals produce a steady rhythm and the muscle contracts to pump blood from the top to the bottom of the heart and then around the body. But sometimes the signals become confused and disorganised, and the regular rhythm is disrupted. The medical term for this is arrhythmia. 
Most arrhythmias fall into one of two main categories:

heart with quick heartbeat tachycardia
QUICK HEARTBEAT  

Tachychardia 
The heart beats too quickly

heart with slow heartbeat bradycardia
SLOW HEARTBEAT 

Bradycadia 
The heart beats too slowly


Atrial fibrillation (AF) is a type of tachycardia and is the most common type of arrhythmia.

heart with normal heartbeat
NORMAL HEARTBEAT  

The heart beats regularly at 60-100 beats per minute

heart with atrial fibrilaltion
ATRIAL FIBRILLATION 

The hearts beats rapidly and irregularly

AF occurs when the electrical signals being sent from the sinoatrial (SA) node (the heart's natural pacemaker) to the right atrium and the left atrium get disrupted by random signals. This overload of signals causes these top two chambers to beat too quickly and lose their rhythm.  They start to "quiver" rather than contract efficiently to pump blood to the ventricles at the bottom of your heart. The medical term for this electrical disturbance and weakened pumping ability is fibrillation.

What are the symptoms of AF?

Symptoms of AF vary from person to person but most commonly include: 

heart with irregular heartbeat
IRREGULAR HEARTBEAT 
man running experiencing breath shortness
SHORTNESS OF BREATH
icon representing feeling of tiredness
TIREDNESS OR A GENERAL FEELING OF BEING UNWELL
icon representing chest discomfort or pain
CHEST DISCOMFORT OR PAIN
icon representing the feeling of dizziness or fainting
DIZZINESS OR FAINTING

The duration of symptoms also varies – from a few minutes to several days, or even weeks at a time.

How can AF cause stroke?

If blood is not pumped efficiently from the top to the bottom chambers of the heart, it may collect in the left atrial appendage (LAA), where it stagnates, creating a dangerous environment for thrombus (blood clot) formation. If a blood clot dislodges from the LAA and travels to the brain, it can block the blood flow and cause a stroke.

People who have AF can have up to a 5x increased risk of stroke.1, 2, 3

Never ignore any of the symptoms of AF – always seek medical advice.

How do patients describe the symptoms of AF?

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 “My heart flip-flops, skips beats, and feels like it’s banging against my chest wall, especially if I’m carrying stuff up my stairs or bending down.”

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 “I was nauseated, light- headed, and weak. I had a really fast heartbeat andfelt like I was gasping for air.”

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 “I had no symptoms at all. I discovered my AFib at a regular check-up. I’m glad we found it early.”

Some people with AF do not experience any symptoms. In ‘silent’ cases like this, AF might be picked up in a standard health check, when investigating another health issue, or via a wearable device (such as a watch) that has health monitoring functionality. 

Because of the potential risks – including an increased stroke risk – symptoms of AF should not be ignored.1

Once diagnosed, AF should not be left untreated even if you are not experiencing symptoms or if your symptoms are mild. 

Diagnosis

If your doctor suspects you may be suffering from an arrhythmia, you will be referred to a cardiologist (heart specialist) or electrophysiologist (specialist in the heart’s electrical system) for consultation and diagnostic tests. Usually, the first tests you undergo will be ECG recordings. If they do not help explain your symptoms, you may need further specialist tests.

icon representing the electro-cardiogram which records the rhytm or wave patterns of your heart for a few seconds or more
ELECTRO-CARDIOGRAM (ECG/EKG) 

Small adhesive pads are attached to your arms, legs and chest and connected by wires to a machine which records the rhythm or wave patterns of your heart for a few seconds or more.

icon representing the Holter Monitor which is a portable ECG monitor.
HOLTER MONITOR 

This is a small, portable ECG monitor that you wear at home, usually for 24 hours or longer. This continuous extended monitoring period increases the chance of any abnormality in your heart’s rhythm being recorded.

icon representing a small,waterproof wearable device which track's the heart activity.
REMOTE CARDIAC MONITOR 

A small, waterproof wearable device that tracks your heart's activity for several weeks as you go about your daily life. It records every single heartbeat and provides detailed data to your healthcare team. If you experience any symptoms, you can press a button on the monitor to mark the event. 

icon representing an implantable cardiac monitor
IMPLANTABLE CARDIAC MONITOR 

An implantable device that captures information automatically when your heart's rhythm falls outside a preset range, or when activated by you. It is placed just under the skin of the chest during a simple procedure and can stay in place for up to several years.

icon representing an echocardiogram

ECHOCARDIOGRAM 
An ultrasound scan which creates a moving picture of your heart to rule out/identify any structural problems with the heart that might be causing your symptoms.

icon representing a scanner used to get more detailed image of your heart

SCANNERS
Scanners (MRI/ Magnetic Resonance Imaging or CT/ Computed Tomography) might be used to generate more detailed images of your heart. 

 Blood test will give you more details on health conditions

BLOOD TESTS
They will give more details on heart-related and other health conditions.

These tests will help your doctors understand if you have an arrhythmia, what type it is, what’s causing it and what treatments might be suitable for you.  


REFERENCES:

1. ESC Press Office. Atrial fibrillation set to affect more than 14 million over-65s in the EU by 2060. European Society of Cardiology. 2019.
2. The Stroke Association. Atrial fibrillation (AF) and stroke
https://www.stroke.org.uk/atrial_fibrillation_and_stroke_guide.pdf. Accessed July 2024 
3. ESC Press Office. Atrial fibrillation set to affect more than 14 million over-65s in the EU by 2060. European Society of Cardiology. 2019.
https://www.escardio.org/The-ESC/Press-Office/Press-releases/Atrial-fibrillation-set-to-affect-more-than-14-million-over-65s-in-the-EU-by-2060

CAUTION: 
This material is for informational purposes only and not meant for medical diagnosis. This information does not constitute medical or legal advice, and Boston Scientific makes no representation regarding the medical benefits included in this information. Boston Scientific strongly recommends that you consult with your physician on all matters pertaining to your health. 

FARAPULSE™ Pulsed Field Ablation System:
The FARAPULSE Pulsed Field Ablation (PFA) System is intended for the isolation of the pulmonary veins in the treatment of paroxysmal atrial fibrillation by rendering targeted cardiac tissue electrically non-conductive to prevent cardiac arrhythmia initiation or maintenance. With all medical procedures there are risks associated with the use of the device. The risks include but are not limited to pain or discomfort, electric shock, hypotension, infection/inflammation, allergic reaction, anesthesia risk, radiation injury/tissue burn, heart failure, renal failure, respiratory distress, arrhythmia, nerve injury (such as phrenic nerve or vagal nerve), gastrointestinal disorders, vessel trauma, cardiac trauma (such as perforation), injury related to adjacent structures (esophageal injury, atrio-esophageal fistula, pulmonary injury), pulmonary vein stenosis, surgical and access complications, muscle spasm, injury due to blood clot or air bubbles in the lungs or other organs, heart attack, TIA, stroke, and/or damage to red blood cells. In rare cases, cardiac arrest or death may occur. Be sure to talk with your doctor so that you thoroughly understand all of the risks and benefits associated with the implantation and use of the device.
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