Atrial fibrillation overview

Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. It affects more than 2 million individuals in the United States, and as many as 160,000 new cases are diagnosed each year. The incidence of atrial fibrillation increases with age, and it is often associated with hypertension, valvular and pulmonary disease, metabolic disorders, and coronary artery disease. It is usually triggered by rapid firing from the pulmonary veins, followed by disorganized and asymmetrical impulse through the atria resulting in over 400 beats/min. The ventricles also respond in an irregular way. A serious consequence resulting from AF is clot formation in the atrium, especially when the atria have enlarged and have areas of pooling blood, which subsequently leads to embolism. Risk of thromboembolism is greater in people with diabetes, hypertension, history of embolism, diseases of the valves, and heart failure.

In atrial flutter, regular atrial rates range from 250 to 350 beats/min. Most people with atrial flutter have some type of underlying heart problem such as hypertension, coronary artery disease, pericarditis, or valvular heart disease. It can also be caused by a congenital heart defect. Atrial flutter increases the patient’s risk of thromboembolism by 3% per year. Prevention and treatment of atrial flutter should be approached as described for atrial fibrillation. Long-term anticoagulation therapy is recommended for both conditions to reduce the risk of thromboembolism. Radiofrequency catheter ablation is very effective and has minimal risks. It can even be considered as an alternative to drug therapy.

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