FAQs regarding atrial fibrillation

Written in association with: Dr Oliver Segal
Published: | Updated: 01/07/2024
Edited by: Conor Lynch

Atrial fibrillation is the latest medical topic up for discussion today. Below, esteemed consultant cardiologist, Dr Oliver Segal, discusses the heart-rhythm-affecting disorder in expert detail.

What is atrial fibrillation, and how does it affect the heart?

Atrial fibrillation is the most common heart rhythm disorder in the world as it mainly occurs due to ageing. It occurs when the electrics in the top chambers in the heart become chaotic. This results in lots of rapid signals being sent to the bottom chambers of the heart, which causes the heart to race.

 

This causes shortness of breath, palpitations, and a racing heart, and increases the risk of death, stroke, and heart failure. Treating the condition early with a procedure called an atrial fibrillation ablation can greatly reduce these risks.

 

Can you explain the different types of atrial fibrillation?

There are four main types. The first type is the one we think that all patients start off with, which is called paroxysmal AF, which means it comes intermittently and stops and starts. The next type is persistent AF. Patients may get symptoms all the time, and unfortunately, treatment is less effective when persistent AF is diagnosed.

 

If AF is left untreated and you have it for more than a year, then it is classified as long-standing persistent AF. The last type is the permanent AF, which is when you have persistent atrial fibrillation, and you and your doctor have both decided that treatments to restore normal rhythm will not be undertaken.

 

What are the main associated symptoms?

It is commonly associated with rapid, irregular palpitations, breathlessness, and tiredness, particularly when exercising. You may find your fitness levels are reduced. Occasionally, it can cause low blood pressure and chest pain.

 

Up to one quarter of patients do not experience symptoms, which can be very problematic, as you may not be diagnosed with AF until you have a stroke or something serious.

 

How common is AF, and who is more likely to develop it?

There are numerous risk factors associated with AF. Age is the main risk factor. Others include structural abnormalities with the heart, high blood pressure, alcohol consumption, thyroid disease (either underactive or overactive), diabetes, and recent chest infections such as pneumonia.

 

To book a consultation today with Dr Oliver Segal, simply visit his Top Doctors profile.

By Dr Oliver Segal
Cardiology

Dr Oliver Segal is one of London’s leading cardiologists and electrophysiologists. Based in the NHS at Barts Heart Centre and UCLH, where he is arrhythmia lead, he sees patients privately at The Harley Street Clinic. He has over 20 years’ experience in the management of all arrhythmias, performing catheter ablation for atrial fibrillation and other rhythms, as well as implanting pacemakers, defibrillators and other cardiac devices
 
Dr Segal is an expert in electrophysiology, focusing on the analysis of irregular heart rhythms. He focuses on seeing patients with rapid palpitations and tachycardias, irregular heartbeats, ectopic or ‘skipped’ beats, pauses and slow heartbeats, dizzy spells and blackouts, including patients with breathlessness and tiredness due to atrial fibrillation (AF). He has performed >2,000 ablations (including the use of three-dimensional and non-contact mapping systems) and >1,500 device implantation procedures. He implants left atrial appendage occlusion (LAAO) devices (the Amulet devices) for patients with AF and high risk of stroke who cannot take anticoagulants or when anticoagulants have failed, leadless pacemakers and conduction system pacemakers. 
 
Dr Segal was awarded an MB BS degree from King's College London in 1995, and later obtained his Doctorate (MD) from the National Heart & Lung Institute, Imperial College London in 2008. Dr Segal's training took him to prestigious institutions, including St Mary’s, The Heart & and St George's Hospitals in London, where he honed his skills in electrophysiology, before earning a coveted fellowship in electrophysiology and devices, with the world-renowned Professor George Klein in Canada. 
 
Dr Segal's professional involvement extends beyond his practice, as he holds key positions within esteemed organisations. He is a member of the Royal College of Physicians and plays a pivotal role as a lead for electrophysiology and arrhythmias at University College London Hospitals. Furthermore, he contributes as a valued member of the European Heart Rhythm Association Exam Setting Committee, the British Heart Rhythm Society, and the Heart Rhythm Society in the USA.
 

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