Andrea Sotirakopoulos, BSc

Atrial fibrillation (AF) is one of the most common sustained arrhythmias encountered by clinicians. Its incidence increases with age and the presence of structural heart disease, although it may also be present in patients without identifiable heart disease. When healthy, the atria contract at a rate that is coordinated with the contractions in the ventricles. In AF instead of beating effectively, the atria produce numerous chaotic electrical impulses that result in a non-organized, quivering movement of the heart muscle called fibrillation. As a result, the ventricles then beat too quickly, generating a rapid pulse rate and possibly allowing the blood to pool and clot. If a piece of the blood clot in the atria becomes lodged in an artery in the brain, a stroke occurs. A rapid or irregular heart rate during AF can cause symptoms such as palpitations, exertional breathlessness, fatigue, or hypotension. AF may be classified as Paroxysmal, defined as recurrent episodes reverting spontaneously or following treatment to sinus rhythm or Chronic, referring to persistent arrhythmia.

Treatment of AF should be of special interest to doctors treating the elderly. The prevalence of AF is 0.5% for the group aged 50 to 59 years and rises to 8.8% in the group aged 80 to 89 years.