Atrial fibrillation
Atrial fibrillation (AF) is a common heart rhythm problem in which the upper chambers of the heart beat irregularly and often fast. It becomes more common with age and is linked to high blood pressure, heart valve disease (including rheumatic heart disease) and thyroid problems. It is not usually immediately dangerous, but it raises the risk of stroke about five times because blood clots can form in the heart. Treatment controls the heart rate and prevents stroke.
Symptoms
- An irregular, fast or pounding heartbeat (palpitations)
- Shortness of breath
- Tiredness and being less able to exercise
- Dizziness or fainting
- Chest discomfort
- Some people have no symptoms at all
Causes
- High blood pressure
- Coronary heart disease and heart failure
- Heart valve disease, including rheumatic heart disease
- An overactive thyroid
- Older age
- Alcohol, lung disease and being overweight
Prevention
- Keep blood pressure under control
- Keep a healthy weight and stay active
- Avoid alcohol
- Cut down on very strong tea, coffee or energy drinks if they trigger palpitations
- Get thyroid problems and heart valve disease treated
Treatment
- Medicines to slow the heart rate or restore a normal rhythm
- Blood thinners (anticoagulants) to prevent stroke, as prescribed, with regular blood tests when needed
- Treating the cause, such as high blood pressure or thyroid disease
- Procedures such as cardioversion or ablation for some people
- Do not start or stop prescription medicines without a doctor — especially blood thinners
Common questions
Why do I need a blood thinner if my heart feels fine?
In AF, blood can pool in the heart and form clots that travel to the brain and cause a stroke, even when you have no symptoms. Blood thinners greatly reduce this risk.
Can I take painkillers with a blood thinner?
Paracetamol is usually the safer choice. Painkillers such as ibuprofen, diclofenac and aspirin raise the risk of bleeding with blood thinners. Always ask your doctor or pharmacist first.