Atrial Fibrillation (AF)
Disease Description
Atrial fibrillation is an irregular and usually rapid atrial rhythm caused by multiple chaotic waves of electrical activation within the atria.
Causes of the Disease
Atrial fibrillation is an arrhythmia with a trigger-based mechanism, in which the trigger is an ectopic focal source of electrical activity. These triggers are most commonly located in the muscular sleeves at the openings of the pulmonary veins — the area where oxygen-rich blood from the lungs enters the left atrium.
Causes of atrial fibrillation may include coronary artery disease, heart valve disease, arterial hypertension, hormonal disorders, use of psychoactive substances, alcohol consumption, and chronic stress.
Symptoms
The main symptoms of atrial fibrillation include weakness and general malaise, palpitations, shortness of breath, reduced exercise tolerance, irregular heartbeats, occasional fainting episodes, and chest pain.
Atrial fibrillation significantly reduces patients’ quality of life, as many live in constant fear of recurrent episodes. In addition, AF increases the risk of stroke severalfold, which represents its primary danger.
Timely detection and treatment of atrial fibrillation help prevent the development of serious complications.
Diagnosis
Atrial fibrillation is diagnosed based on clinical data, electrocardiography (ECG) recorded during an episode, or findings from 24-hour (Holter) ECG monitoring.
Implantable electronic devices — such as pacemakers, implantable cardioverter-defibrillators (ICDs), and subcutaneous ECG monitors — play an important role in diagnosis. These devices can automatically detect rhythm disturbances and provide valuable diagnostic information to the physician.
Treatment
Treatment of atrial fibrillation includes the prescription of medications aimed at preventing arrhythmic episodes and reducing the risk of stroke. It is also essential to treat associated conditions such as arterial hypertension and heart failure, as the mechanisms of AF progression are closely linked to these disorders.
If antiarrhythmic drug therapy is ineffective, radiofrequency catheter ablation (RFA) — specifically pulmonary vein isolation — may be performed.
The effectiveness of RFA is higher than that of medication therapy, and in many cases it allows patients to eliminate arrhythmic episodes altogether.
Treatment Prognosis
The presence of atrial fibrillation — whether symptomatic or asymptomatic — is associated with increased risks of hospitalization, development and progression of heart failure, stroke, and increased mortality.
It is crucial to begin AF treatment as early as possible and to apply a comprehensive approach that includes management of coexisting conditions.
Catheter ablation significantly improves quality of life in patients with atrial fibrillation by achieving long-term remission or substantially reducing the overall burden of the arrhythmia.