Atrial fibrillation (AF) is a common heart rhythm disorder in which the heart beats in an irregular and often rapid rhythm.

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Instead of beating in a coordinated way, the upper chambers of the heart (the atria) beat irregularly, which can cause symptoms such as palpitations, breathlessness or fatigue.

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A cardiology assessment can determine whether symptoms are caused by atrial fibrillation and whether treatment is required.

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Symptoms of atrial fibrillation

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Symptoms can vary between individuals. Some people have noticeable symptoms, while others may have very few.

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Symptoms may include:

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• palpitations or awareness of an irregular heartbeat
• breathlessness
• fatigue or reduced exercise tolerance
• dizziness or lightheadedness
• occasional chest discomfort

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In some cases atrial fibrillation is discovered incidentally during routine testing.

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Causes of atrial fibrillation

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Atrial fibrillation becomes more common with age but can occur in otherwise healthy individuals.

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Possible contributing factors include:

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• high blood pressure
• coronary artery disease
• heart valve disease
• cardiomyopathy
• thyroid problems
• excessive alcohol consumption
• sleep apnoea

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Sometimes no clear cause is identified.

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Why atrial fibrillation is important

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Atrial fibrillation can increase the risk of stroke because blood may pool in the heart and form small clots that can travel to the brain.

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For this reason, treatment may include medications to reduce stroke risk as well as treatments to control the heart rhythm.

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How atrial fibrillation is investigated

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Assessment usually includes:

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• electrocardiogram (ECG)
• ambulatory ECG monitoring
• echocardiography
• blood tests to assess contributing factors

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Additional tests may sometimes be required to assess the heart in more detail.

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Treatment for atrial fibrillation

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Treatment depends on the type of atrial fibrillation, symptoms and overall cardiovascular risk.

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Management may include:

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• medications to control heart rate or rhythm
• anticoagulant medication to reduce stroke risk
• treatment of contributing conditions such as high blood pressure
• in some cases, catheter ablation procedures

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A personalised treatment plan will be recommended based on individual circumstances.

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When to seek medical advice

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You should consider cardiology assessment if you experience:

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• persistent palpitations
• an irregular heartbeat
• unexplained breathlessness
• episodes of dizziness or fatigue
• known atrial fibrillation requiring review

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Consultation

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Private cardiology consultations with Dr Thomas Heseltine are available at Spire Murrayfield Hospital Wirral.

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Appointments include a detailed assessment of symptoms and cardiovascular risk, with advice regarding appropriate investigations and treatment if required.