What Is Paroxysmal Atrial Fibrillation?

With atrial fibrillation (AFib), your heartbeat loses its rhythm and causes a quiver or fluttering in your chest. It can last for a few seconds or a few days, and it can raise your risk of stroke, blood clots, and other heart problems.

A pulse of electricity tells the four chambers in your heart when to squeeze to send the blood through. Sometimes that signal gets interrupted or doesn't follow its usual path. That makes one of the upper chambers (called the atria) quiver, or fibrillate. That gives you the feeling that your heart is skipping a beat or racing. It's a condition called heart palpitations.

There are different kinds of AFib. The kind you have depends on the reason for it and on how long it lasts. When your heartbeat returns to normal within 7 days on its own or with treatment, it's known as paroxysmal atrial fibrillation.

It can happen a few times a year or as often as every day. It often becomes a permanent condition that needs regular treatment.

Symptoms

The most recognizable symptom is that feeling of a rapid, fluttering heartbeat. You also might:

  • Feel weak or short of energy
  • Be dizzy or confused
  • Have shortness of breath
  • Use the bathroom more often
  • Sweat
  • Feel anxious

You may feel chest pain or pressure. If you do, call 911 right away. You may be having a heart attack.

Causes

Doctors don't always know what causes paroxysmal atrial fibrillation. It often happens because your heart has been damaged by things like coronary heart disease or high blood pressure. If that damage affects the part of your heart that sends the electrical pulses that control your heartbeat, those pulses can come too fast or at the wrong time.

You're more likely to have paroxysmal atrial fibrillation as you get older. Your odds also go up if you have:

People who drink several alcoholic drinks at a time sometimes have paroxysmal atrial fibrillation. Doctors don't know, though, why this happens. This is sometimes called "holiday heart syndrome" because it was first noticed after weekends or holidays when many people drink more.

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Diagnosis

If your doctor thinks you have atrial fibrillation, he'll give you an exam and ask questions about your medical and family history. He'll also ask about your symptoms and if you smoke or drink caffeine or alcohol.

You might have some of the following tests:

  • Electrocardiogram, also known as an EKG, which records your heart's rate, rhythm, and electrical impulses
  • Echocardiogram, which uses sound waves to make a picture of your heart
  • X-ray to look for signs of related heart problems
  • Blood tests to look for signs of other illnesses that can cause fibrillation
  • Stress test, in which doctors check your heart's performance after exercise
  • A Holter monitor, which measures and records your heart's activity for a day or two

Treatment

If your problem is caused by a condition like an overactive thyroid gland or high blood pressure, you'll get medication to control those issues.

Generally, your doctor will try to keep your heartbeat steady and prevent problems like blood clots. The most common way to treat atrial fibrillation is with drugs that keep your heartbeat at a slower rate. You'll also take medications that thin your blood to lower your risk of blood clots or stroke. These can raise your risk of bleeding, though, so you might be asked to cut back on some activities that can lead to injuries.

If your symptoms are more serious, you might be given drugs to keep your heartbeat at a more consistent rhythm. You may need to take some of these only when you feel your heart start to flutter.

If other treatments don't work for you, your doctor might recommend something called ablation. He'll put a wire into your heart through a vein in one of your arms or legs. The wire carries energy that destroys groups of cells that might be blocking your heart's electrical signals. This works about 75% to 80% of the time.

Your doctor also might recommend you change your diet, get more exercise, or quit habits like smoking, which raises your risk of heart disease.

WebMD Medical Reference Reviewed by William Blahd, MD on January 20, 2017

Sources

SOURCES:

American Heart Association.

National Heart, Lung and Blood Institute: "What Is Atrial Fibrillation?"

American Family Physician: "Diagnosis and Treatment of Atrial Fibrillation."

American College of Cardiology/American Heart Association: "Management of Patients with Atrial Fibrillation."

Heart Rhythm Society: "Atrial Fibrillation."

American Family Physician: "Catheter Ablation of Supraventricular Arrhythmias and Atrial Fibrillation."

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