Atrial Fibrillation

If you are healthy and your heart is working normally you are likely to have a regular resting heart rate of around 60 to 90 beats per minute. If you are experiencing atrial fibrillation (AF), however, you may notice your heartbeat becoming irregular and speeding up for no apparent reason. These feelings or "palpitations" may occur constantly or only from time to time. They are unpleasant and worrying and they should not be ignored as they might mean that something is seriously wrong with your heart.

Atrial fibrillation happens when the electrical control of your heartbeat becomes disrupted. Normally, your heartbeat is controlled by electrical signals from its own natural pacemaker, called the sino-atrial node. These signals cause the upper chambers of your heart (the atria) to squeeze blood into the lower chambers (the ventricles) which then squeeze blood out into your blood vessels. The regular boom-boom of a healthy heart is the sound of the contracting atria quickly followed by the contracting ventricles.

In atrial fibrillation, however, the electrical signals become erratic, causing the atria and ventricles to contract out of sync. Instead of beating normally, the upper chambers - the atria - start making repetitive twitching movements known as 'fibrillations'. This hampers the movement of blood from the atria into the ventricles. The ventricles respond by beating faster and more irregularly. It is this irregular ventricular beat you feel when you have an episode of AF.

Atrial Fibrillation occurs in around one in 25 adults over 60 years and more than one in 10 adults over 80 years old. Patients with AF experience a five-fold increased risk of stroke compared to those with a normal heartbeat and, as a result, across 22 European countries with a combined population of 500 million, there are almost one million strokes each year, making it the second leading cause of death worldwide.

Anticoagulant therapy is an effective means of lowering the risk of stroke in patients with AF. A study conducted by the Stroke Council of the American Heart Association highlights that treatment with anticoagulants can reduce the risk of stroke for patients with AF by an average of 68%. However, it is estimated that only half of patients with AF currently receive appropriate anticoagulant treatment.

The incidence of AF continues to increase, in line with an ageing population throughout the developed world, and the high economic cost of treating stroke means there is a clear need to address the under-utilisation of anticoagulant therapy and to improve the management of patients' treatment to protect them from stroke. The National Institute for Clinical Excellence (NICE) published guidelines for the treatment of AF in 2006. www.nice.org.uk.

AntiCoagulation Europe has an information leaflet Living with Atrial Fibrillation. There is also an article Everything you need to know about Atrial fibrillation?