Atrial fi­bril­la­ti­on

Atrial fibrillation can come and go or be permanent. Medical treatment is necessary as the risk of a stroke or other secondary diseases is increased.

Some people hardly notice that they have atrial fibrillation, while for others the symptoms are clearly perceptible, for example:

• Palpitations
• Irregular pulse
• Shortness of breath
• Weakness / loss of performance
• Dizziness
• Heart palpitations

Important causes of acquired heart valve defects are

• rheumatic fever (preferably mitral and aortic valve)
• Degenerative changes in valve components
• Infections (e.g. endocarditis, myocarditis or a combination of both)
• underlying cardiac diseases (condition after myocardial infarction, overstretching of the valves in pulmonary hypertension)

If they develop over a long period of time, heart valve defects can be haemodynamically compensated by adaptations of the heart (e.g. hypertrophy). In the case of sudden development (e.g. endocarditis), the possibilities of compensation are limited, resulting in an acute course.

In atrial fibrillation, the atria of the heart usually beat too quickly and uncontrollably, like an "electrical storm". These excitations are transmitted irregularly to the ventricles. As a result, blood circulation in the heart is unfavourable and small blood clots can form, which can then lead to a stroke.

Atrial fibrillation is diagnosed in an ECG and/or 24-hour ECG.

As a first measure, blood thinning with Marcoumar or Xarelto is recommended to reduce the risk of stroke. However, this does not yet eliminate atrial fibrillation.

The following options are available to bring the heart back into its normal rhythm:

• Medication, e.g. with a beta blocker
• Electrocardioversion, targeted electric shock
• Ablation of the affected areas in the atrium