If the heart suddenly races or beats irregularly, atrial fibrillation is often behind it. BIf the arrhythmia is left untreated, there is a risk of stroke and heart attack.
Atrial fibrillation is one of the most common cardiac arrhythmias. In Germany, an estimated 1.5 to 2 million people are affected. Although the disease, unlike ventricular fibrillation, is not immediately life-threatening, it should be treated quickly. Otherwise, the risk of a stroke increases by a factor of four to five.
What happens in atrial fibrillation?
Atrial fibrillation is triggered by electrical disturbances in the cardiac conduction system, which usually originate in the pulmonary veins. These open into the left atrium. Because of the irregular heartbeat, the ventricles and atrium no longer contract in a coordinated manner. They begin to tremble and “flicker” in an uncoordinated manner.
The result is that blood pools in the bulges of the atrium. It can clump together and cause small blood clots to form. If these are flushed out and reach the head via arteries with the bloodstream, they may block a cerebral vessel. Then there is a risk of a stroke.
Over time, atrial fibrillation can become chronic. The heart chambers then become powerless and no longer pump enough blood into the systemic circulation.
If you have these symptoms, see a doctor immediately
Heart palpitations and sudden palpitations are typical symptoms of atrial fibrillation. Some patients also tend to sweat, complain of shortness of breath and poor performance. Dizziness and chest pain can also occur. Therefore, many patients react with fear and anxiety, especially when they first appear.
Sometimes the heartbeats can even be felt in the throat. There is often inner restlessness and fear, the pulse becomes irregular and accelerates. “If you have these symptoms, you should see a doctor immediately,” says Professor Andreas Götte from the Scientific Advisory Board of the German Heart Foundation and head of the Department of Cardiology at the St. Vincenz Hospital in Paderborn.
“The doctor can use an electrocardiogram (ECG), long-term ECG or event recorder to clarify whether the palpitations are just a harmless irregularity of the heartbeat, whether there is atrial fibrillation or another cardiac cause.”
Every second person has no complaints
However, not all patients show symptoms. The German Heart Foundation estimates that this could even be the case for every second person affected. The diagnosis of the cardiac arrhythmia is then at best made by chance. Sometimes the disease goes undetected. Those affected are then not even aware of the risks of serious secondary diseases and they have no chance of taking appropriate protective measures.
“Atrial fibrillation is a cardiac arrhythmia that must be taken seriously. Because even if it occurs – as in some patients – without pronounced symptoms, it can become a life-threatening danger and lead to cardiac insufficiency and stroke,” warns heart specialist Professor Thomas Voigtländer, Chairman of the Board of the German Heart Foundation.
Risk factors: age, underlying diseases, lifestyle
The development of atrial fibrillation is favored by many risk factors. Some are suggestible, some are not. In addition to genetic factors, this also includes gender (men are more frequently affected) and age. While the frequency of cardiac arrhythmia is less than 1 percent among those under 50, it is already 4 to 6 percent among those over 60. From the age of 75, every tenth person is affected by atrial fibrillation.
In addition, there are a number of avoidable risk factors that are caused by an unhealthy lifestyle:
- excessive alcohol consumption
- Smoking
- severe overweight (obesity)
- lack of exercise
Constant stress and disturbances in the mineral balance (potassium and magnesium) can also promote atrial fibrillation, even if they are rarely the sole cause.
In many cases, atrial fibrillation can be traced back to underlying diseases. They can be the cause of the arrhythmia or jointly responsible:
- high blood pressure
- Coronary heart disease
- Heart attack
- Diseases of the heart muscle
- cardiac insufficiency
- hyperthyroidism
- Diabetes Typ 2
- leaking heart valves
- Nocturnal breathing pauses (sleep apnea)
- inflammatory diseases such as rheumatism
- chronic lung conditions such as COPD
- vascular diseases
- chronic renal dysfunction
How is atrial fibrillation diagnosed?
If atrial fibrillation is suspected, the doctor first records the medical history (anamnesis) of the patient. A physical examination is then usually carried out, during which the pulse, blood pressure and heart rate are checked.