Atrial fibrillation
Atrial fibrillation (AF or A-fib) is an abnormal heart rhythm (arrhythmia) characterized by the rapid and irregular beating of the atrial chambers of the heart. It often begins as short periods of abnormal beating, which become longer or continuous over time. It may also start as other forms of arrhythmia such as atrial flutter that then transform into AF. Often episodes have no symptoms. Occasionally there may be heart palpitations, fainting, lightheadedness, shortness of breath, or chest pain. The disease is associated with an increased risk of heart failure, dementia, and stroke. It is a type of supraventricular tachycardia.
High blood pressure and valvular heart disease are the most common alterable risk factors for AF. Other heart-related risk factors include heart failure, coronary artery disease, cardiomyopathy, and congenital heart disease. In the developing world, valvular heart disease often occurs as a result of rheumatic fever. Lung-related risk factors include COPD, obesity, and sleep apnea. Other factors include excess alcohol intake, tobacco smoking, diabetes mellitus, and thyrotoxicosis. However, half of the cases are not associated with any of these risks. Healthcare professionals may suspect AF by feeling the pulse and confirm the diagnosis by interpreting an electrocardiogram (ECG). A typical ECG in AF shows irregularly spaced QRS complexes without P waves.
Healthy lifestyle changes, such as weight loss in people with obesity, increased physical activity, and drinking less alcohol, can lower the risk for atrial fibrillation and reduce its burden if it occurs. AF is often treated with medications to slow the heart rate to a near-normal range (known as rate control) or to convert the rhythm to normal sinus rhythm (known as rhythm control). Electrical cardioversion can convert AF to normal heart rhythm and is often necessary for emergent use if the person is unstable. Ablation may prevent recurrence in some people. For those at low risk of stroke, AF does not necessarily require blood-thinning though some healthcare providers may prescribe aspirin or an anti-clotting medication. For those at more than low risk, experts generally recommend an anti-clotting medication. Anti-clotting medications include warfarin and direct oral anticoagulants. Most people are at higher risk of stroke. While these medications reduce stroke risk, they increase rates of major bleeding.
Atrial fibrillation is the most common serious abnormal heart rhythm and, as of 2020, affects more than 33 million people worldwide. As of 2014, it affected about 2 to 3% of the population of Europe and North America. This was an increase from 0.4 to 1% of the population around 2005. In the developing world, about 0.6% of males and 0.4% of females are affected. The percentage of people with AF increases with age with 0.1% under 50 years old, 4% between 60 and 70 years old, and 14% over 80 years old being affected. A-fib and atrial flutter resulted in 193,300 deaths in 2015, up from 29,000 in 1990. The first known report of an irregular pulse was by Jean-Baptiste de Sénac in 1749. Thomas Lewis was the first doctor to document this by ECG in 1909.
Q189331
abnormal heart rhythm
Concept
Q1001150
rapid and irregular beating
UNK
Q1074839
atrial chambers of the heart
Concept
Q257319
beating
Concept
Q1506572
atrial flutter
Concept
Q1123260
palpitations
Concept
Q180007
fainting
Concept
Q57823162
lightheadedness
Concept
Q188008
shortness of breath
CEL
Q180762
chest pain
Concept
Q181754
heart failure
Concept
Q83030
dementia
Concept
Q12202
stroke
Concept
Q1598909
supraventricular tachycardia
Concept
Q41861
High blood pressure
Concept
Q1130519
valvular heart disease
Concept
Q844935
coronary artery disease
Concept
Q847583
cardiomyopathy
Concept
Q939364
congenital heart disease
Concept
Q753904
rheumatic fever
Concept
Q199804
COPD
Concept
Q12174
obesity
Concept
Q213600
sleep apnea
Concept
Q47146337
alcohol
Concept
Q7212330
tobacco smoking
Concept
Q12206
diabetes mellitus
Concept
Q16499
thyrotoxicosis
Concept
Q191733
pulse
Concept
Q79785
electrocardiogram
Concept
Q1969239
QRS complexes
UNK
Q4924939
P waves
UNK
Q153
alcohol
Concept
Q12335414
normal sinus rhythm
UNK
Q1729126
Electrical cardioversion
Concept
Q1809554
Ablation
UNK
Q18216
aspirin
Concept
Q215118
anti-clotting medication
Concept
Q407431
warfarin
Concept
Q215118
direct oral anticoagulants
Concept
Q166019
major bleeding
Concept
Q177323
developing world
Concept
Q1506572
atrial flutter
Concept
Q437347
Jean-Baptiste de Sénac
PER
Q262827
Thomas Lewis
PER
Q815819
Atrial fibrillation
Concept
Q815819
Atrial fibrillation
Concept
2020-01-01T00:00:00Z^^http://www.w3.org/2001/XMLSchema#dateTime
2020
DATE
2014-01-01T00:00:00Z^^http://www.w3.org/2001/XMLSchema#dateTime
2014
DATE
2005-01-01T00:00:00Z^^http://www.w3.org/2001/XMLSchema#dateTime
2005
DATE
2015-01-01T00:00:00Z^^http://www.w3.org/2001/XMLSchema#dateTime
2015
DATE
1990-01-01T00:00:00Z^^http://www.w3.org/2001/XMLSchema#dateTime
1990
DATE
1749-01-01T00:00:00Z^^http://www.w3.org/2001/XMLSchema#dateTime
1749
DATE
1909-01-01T00:00:00Z^^http://www.w3.org/2001/XMLSchema#dateTime
1909
DATE
+33^^http://www.w3.org/2001/XMLSchema#decimal
33
NUMBER
+2^^http://www.w3.org/2001/XMLSchema#decimal
2
NUMBER
+3^^http://www.w3.org/2001/XMLSchema#decimal
3
NUMBER
+0.4^^http://www.w3.org/2001/XMLSchema#decimal
0.4
NUMBER
+1^^http://www.w3.org/2001/XMLSchema#decimal
1
NUMBER
+0.6^^http://www.w3.org/2001/XMLSchema#decimal
0.6
NUMBER
+0.4^^http://www.w3.org/2001/XMLSchema#decimal
0.4
NUMBER
+0.1^^http://www.w3.org/2001/XMLSchema#decimal
0.1
NUMBER
+50^^http://www.w3.org/2001/XMLSchema#decimal
50
NUMBER
+4^^http://www.w3.org/2001/XMLSchema#decimal
4
NUMBER
+60^^http://www.w3.org/2001/XMLSchema#decimal
60
NUMBER
+70^^http://www.w3.org/2001/XMLSchema#decimal
70
NUMBER
+14^^http://www.w3.org/2001/XMLSchema#decimal
14
NUMBER
+80^^http://www.w3.org/2001/XMLSchema#decimal
80
NUMBER
+193.300^^http://www.w3.org/2001/XMLSchema#decimal
193,300
NUMBER
symptoms and signs
medical condition treated
medical condition treated