Main Cause of Atrial Fibrillation (AF)

Introduction

Atrial fibrillation (AF) is the most common type of arrhythmia, affecting millions of people worldwide. It occurs when the electrical signals in the heart become disorganized, causing the atria (upper chambers of the heart) to quiver instead of contracting properly.

Main Cause of Atrial Fibrillation

The main cause of AF is structural or electrical abnormalities in the atria, often due to underlying cardiovascular or systemic conditions. The most common causes include:

1. High Blood Pressure (Hypertension)

  • Increased pressure can lead to atrial enlargement and fibrosis (scarring), which disrupts electrical conduction.

2. Coronary Artery Disease (CAD)

  • Blockages in the coronary arteries can reduce blood flow to the heart, potentially leading to ischemia (lack of oxygen), which increases the risk of AF.

3. Heart Valve Diseases

  • Conditions such as mitral valve stenosis or regurgitation can cause left atrial enlargement, leading to AF.

4. Heart Failure

  • Weakening of the heart muscle causes structural changes in the atria, making AF more likely.

5. Obesity and Metabolic Syndrome

  • Excess weight and metabolic disorders increase inflammatory markers, which negatively affect heart rhythm.

6. Diabetes Mellitus

  • Chronic high blood sugar levels lead to changes in heart tissue, predisposing patients to AF.

7. Thyroid Disorders (Hyperthyroidism/Hypothyroidism)

  • An overactive thyroid (hyperthyroidism) increases heart rate, which can trigger AF.

8. Sleep Apnea

  • Interruptions in breathing during sleep cause oxygen deprivation and increased stress on the heart, contributing to AF.

9. Excessive Alcohol and Stimulants

  • High alcohol consumption (known as 'Holiday Heart Syndrome') and stimulants (caffeine, nicotine, drugs) can provoke arrhythmias.

10. Genetic Predisposition

  • Some individuals have inherited conditions that make them more prone to developing AF.

Conclusion

Atrial fibrillation is rarely caused by a single factor. Instead, it is usually the result of multiple contributing factors, including hypertension, coronary artery disease, and lifestyle choices. Understanding these risk factors is crucial for prevention and effective management.

Source recommendations

1. 2023 European Society of Cardiology (ESC) Guidelines for the Management of Atrial Fibrillation

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Atrial-Fibrillation
  2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
  3. https://www.jacc.org/doi/10.1016/j.jacc.2023.10.021
  4. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/CVD-and-Diabetes-Guidelines
  5. https://pubmed.ncbi.nlm.nih.gov/32860505/

2. 2023 American Heart Association (AHA), American College of Cardiology (ACC), and Heart Rhythm Society (HRS) Guidelines for the Management of Patients with Atrial Fibrillation

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
  2. https://pubmed.ncbi.nlm.nih.gov/38033089/
  3. https://www.hrsonline.org/guidance/clinical-resources/2023-accahaaccphrs-guideline-diagnosis-and-management-patients-atrial-fibrillation
  4. https://www.jacc.org/doi/10.1016/j.jacc.2023.10.021
  5. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2023/11/27/19/46/2023-acc-guideline-for-af-gl-af

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