Atrial Fibrillation: A guide to causes, risks & treatments
Understanding Atrial Fibrillation: A Guide to Causes, Risks, and Treatment
Atrial fibrillation (AF) is the most common heart rhythm disorder, affecting approximately 1.5 million people in the UK, with prevalence increasing with age. This blog explores the causes, symptoms, health implications, and treatment options for AF, alongside the importance of timely intervention for better outcomes.
Aetiology of Atrial Fibrillation
AF occurs when the heart’s electrical impulses in the atria become disorganised, leading to an irregular and often rapid heart rhythm. This disruption can result in poor blood flow to the body. Factors contributing to AF include:
Age: The risk of AF rises significantly in individuals over 65 years old.
Cardiovascular Conditions: Hypertension, heart failure, coronary artery disease, and valvular heart disease are key contributors.
Lifestyle Factors: Excessive alcohol intake, smoking, and obesity increase susceptibility.
Other Conditions: Diabetes, hyperthyroidism, and sleep apnea are also linked to AF.
Genetics: In some cases, AF may have a familial predisposition.
Symptoms of Atrial Fibrillation
AF can present with a range of symptoms, which may vary in severity and frequency. Common symptoms include:
Palpitations: A sensation of rapid, irregular, or pounding heartbeats.
Fatigue: Feeling unusually tired or drained.
Shortness of Breath: Difficulty breathing, especially during physical activity.
Dizziness or Lightheadedness: Feeling faint or unsteady.
Chest Discomfort: Mild to moderate chest pain or pressure.
Reduced Exercise Capacity: Inability to engage in activities without becoming easily fatigued.
In some cases, AF may be asymptomatic and only detected during a routine medical check-up or investigation.
Demographics and Health Burden
AF’s prevalence increases with age, affecting up to 10% of individuals over 80. Men are slightly more likely than women to develop AF, although women experience a higher stroke risk once diagnosed.
From a public health perspective, AF contributes significantly to morbidity and mortality. AF increases the risk of stroke by fivefold, with AF-related strokes accounting for 20% of all ischemic strokes in the UK. Each year, there are approximately 40 AF-related strokes daily, many of which could be prevented with appropriate management (Stroke Association, 2022).
Demographics and Health Impact in Scotland
AF is more common in older adults, with prevalence increasing with age. Men are slightly more prone to developing AF, but women with AF have a higher stroke risk. In Scotland, AF-related hospital admissions have risen by 33% over a five-year period, highlighting the growing healthcare burden.
Treatment Options
Management of AF focuses on reducing symptoms, preventing complications like stroke, and restoring normal heart rhythm. Options include:
Medications:
Anticoagulants (e.g., warfarin, DOACs like apixaban) reduce stroke risk.
Rate Control (e.g., beta-blockers, calcium channel blockers) manage heart rate.
Rhythm Control (e.g., antiarrhythmics) restores normal rhythm.
Electrical Cardioversion: This procedure delivers a controlled electric shock to the heart to reset its rhythm.
Catheter Ablation: A minimally invasive procedure that targets the faulty electrical pathways causing AF. This is particularly effective for symptomatic AF and is often performed by an electrophysiologist.
Lifestyle Modifications:
Weight management, reducing alcohol intake, and smoking cessation.
Managing comorbid conditions like hypertension and diabetes.
NHS Waiting Lists and the Importance of Timely Care
Delays in diagnosing and treating AF can have serious health consequences. As of March 2024, over 414,000 people in England were on heart care waiting lists, a record high (British Heart Foundation, 2024). Evidence shows that prolonged waits for treatment can lead to worsening symptoms, increased risk of stroke, and poorer overall outcomes (BMJ Open, 2021).
At Hourglass Wellbeing, we recognise the critical importance of timely intervention. Our team of expert Cardiologists, including an experienced Electrophysiologist, provide state-of-the-art care with minimal waiting times. This ensures our patients receive rapid diagnosis and treatment, reducing the risk of complications and improving quality of life.
Why Choose Hourglass Wellbeing?
At Hourglass Wellbeing, we pride ourselves on offering:
Specialist Expertise: Our team includes a dedicated Electrophysiologist with an operating platform for invasive investigations such as EP study, and procedures like mapping and ablation, delivering advanced care tailored to individual needs.
Rapid Access: With significantly shorter waiting times compared to current NHS lists, we prioritise timely consultations and investigations. Our average waiting time for consultation, ECG and Holter (heart rhythm monitoring) is usually < 2 weeks.
Patient-Centric Care: We work closely with our patients to provide personalised treatment plans, helping them regain control of their health. We consider all domains of wellbeing implicated with the cardiac condition at hand - lifestyle, fitness, nutrition and mental wellbeing.
If you’re experiencing symptoms of atrial fibrillation, such as palpitations, fatigue, or shortness of breath, don’t delay seeking care. Contact us today to schedule a consultation and take the first step towards better heart health.
The British Heart Foundation is an excellent resource for further information on Atrial Fibrillation.
References
Stroke Association. (2022). Atrial Fibrillation and Stroke. Available at: https://www.stroke.org.uk
British Heart Foundation. (2024). Waiting List Crisis. Available at: https://www.bhf.org.uk
BMJ Open. (2021). Impact of Waiting Times on AF Outcomes. Available at: https://bmjopen.bmj.com
