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Atrial Fibrillation

Atrial fibrillation is a common cause of palpitations. Patients are frequently older but may be in their thirties or forties. Atrial fibrillation is one of the more benign causes of palpitations. In general, palpitations presumed to be ventricular in origin are considered far more serious. The search for the cause of the atrial fibrillation is generally more important than the disease itself, since it may be caused by a serious medical condition (e.g., MI, hypertension, pulmonary embolism, hyperthyroidism, alcohol withdrawal or use, hypertension, or valvular disease)


The heart's structure are the most common cause of atrial fibrillation. Diseases affecting the heart's valves or pumping system also are likely causes, as is long-term high blood pressure. But, some people who have atrial fibrillation don't have underlying heart disease, a condition called lone atrial fibrillation. In lone atrial fibrillation, the cause is often initially unclear.

Possible causes of atrial fibrillation include:

  • High blood pressure
  • Abnormal heart valves
  • Sick sinus syndrome — this occurs when the heart's natural pacemaker stops functioning properly
  • Emphysema
  • Stress due to pneumonia, surgery or other illnesses
  • Pulmonary embolism
  • Mostly Alcohol use
  • Dysfunction of the heart's natural pacemaker, the sinus node


  • Palpitations, irregular
  • Chest pain, shortness of breath, if decompensated from the arrhythmia
  • Syncope (rarely)
  • Symptoms of the cause of the atrial fibrillation (see above)


  • Rapid irregular heartbeat
  • Peripheral pulse, heart one dissociation (i.e., more heartbeats heard than felt at the radial pulse)
  • Signs of CHF, if decompensated
  • Slow irregular heartbeat can occur if AV node disease
  • No signs (between episodes)
  • Signs of the underlying cause


Treatments for atrial fibrillation include medications and procedures to regulate heart rhythm. The goals of treating atrial fibrillation include:

  • Restoring the heart to a normal rhythm (rhythm control)
  • Slowing the heart rate (rate control)
  • Preventing blood clots

Treating atrial fibrillation is important for several reasons. An irregular, rapidly beating heart can weaken the heart muscle and cause it to dilate. This can increase your risk of developing heart failure or having chest pain. Also, atrial fibrillation can greatly increase your risk of having a stroke.

Most people are able to live full and active lives while being treated for atrial fibrillation. To stay healthy, you will probably need to take medications, including an anticoagulant or aspirin, medications to slow heart rate.


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