Atrial Fibrillation: Causes and Risk Factors

Introduction

Atrial fibrillation (AF) is the most common type of irregular heart rhythm (arrhythmia). It occurs when the upper chambers of the heart (atria) beat chaotically and irregularly, leading to inefficient blood flow. Let's explore the causes and risk factors of AF in a structured way.

Main Causes of Atrial Fibrillation

1. Heart-Related Conditions:

  • Hypertension (High Blood Pressure): Increased pressure makes the heart work harder, leading to atrial enlargement and AF.
  • Coronary Artery Disease (CAD): Blocked arteries reduce blood flow, increasing AF risk.
  • Heart Failure: Weak heart muscles can cause electrical instability in the atria.
  • Heart Valve Diseases: Especially mitral valve problems creating turbulence in blood flow.
  • Congenital Heart Defects: Structural heart issues present from birth.

2. Non-Cardiac Causes

  • Hyperthyroidism: Overactive thyroid hormone levels can overstimulate the heart.
  • Diabetes: High blood sugar levels contribute to heart damage and arrhythmias.
  • Chronic Lung Diseases: Conditions like COPD can lead to increased heart strain.
  • Obstructive Sleep Apnea (OSA): Interrupted breathing at night affects heart rhythm.
  • Excessive Alcohol Use: Known as 'Holiday Heart Syndrome,' binge drinking can trigger AF.
  • Stimulants & Drug Use: Including caffeine, nicotine, and illicit drugs.

3. Lifestyle & Genetic Factors

  • Obesity: Increases risk due to strain on the heart.
  • Aging: AF becomes more common after the age of 60.
  • Genetics: Family history plays a role in susceptibility.
  • Excessive Stress and Poor Sleep: Can trigger abnormal heart rhythms.

Conclusion

Atrial fibrillation has multiple causes, ranging from cardiovascular diseases to lifestyle factors. Identifying and managing these risk factors is essential for preventing or controlling AF.

Source recommendations

1. European Society of Cardiology (ESC) Guidelines on Atrial Fibrillation

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Atrial-Fibrillation
  2. https://academic.oup.com/eurheartj/article/42/5/373/5899003
  3. https://www.escardio.org/static-file/Escardio/Guidelines/Documents/ehaa612.pdf
  4. https://academic.oup.com/eurheartj/article/45/36/3314/7738779
  5. https://pubmed.ncbi.nlm.nih.gov/32860505/

2. American Heart Association (AHA) / American College of Cardiology (ACC) / Heart Rhythm Society (HRS) Guidelines on Atrial Fibrillation Management

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
  2. https://pubmed.ncbi.nlm.nih.gov/38033089/
  3. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000665
  4. https://www.hrsonline.org/guidance/clinical-resources/2023-accahaaccphrs-guideline-diagnosis-and-management-patients-atrial-fibrillation
  5. https://www.acc.org/Latest-in-Cardiology/Articles/2023/11/29/18/58/New-ACC-AHA-Guideline-Focuses-on-Diagnosis-Management-of-AFib-gl-af

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