One theory for patients with high blood pressure, where the high pressure in the heart stretches the pulmonary veins altering and distorting the atrial tissue there. It is not fully understood why the pulmonary veins are the usual location for the AF triggers and what makes the cells within the veins become active. The rogue cells are usually grouped at the junction between the left atrium and the veins that drain blood from the lungs to the heart (pulmonary veins). These frequent ectopic beats are the trigger for AF. In people who experience AF however groups of rogue atrial cells are producing ectopic beats rapidly and very frequently. Occasional ectopic beats are experienced very commonly in people with normal hearts. This is experienced as a skipped heart beat which makes the heart feel irregular for a few seconds, as opposed to AF which makes the heart feel irregular for much longer. It is quite normal for other heart cells to occasionally activate spontaneously at the wrong time causing an ectopic (meaning in the wrong place) or extra heart beat. The normal heart cells are dominated by the sinus node and they activate only after they receive the electrical signal from the sinus node (link to electrical system of the heart). Although the sinus node is usual pacemaker of the heart, all the cells in the heart have the potential to spontaneously activate.
These treatments don’t cure AF, they just tip the scales back in your favour and if patients don’t take care of themselves, inevitably the AF will return as their age and reversible promoters gradually tip the scales back the other way.ĪF is started by a trigger. As one gets older the scales gradually tip towards AF and that progress can be delayed by modifying your reversible risk factors (weight, alcohol, fitness) and having treatments like drugs and ablation. It can be helpful to think of AF risk as a balancing of scales with on one side the promoters and on the other side the reducers. AF is also strongly associated with underlying cardiovascular problems such as high blood pressure, heart failure, coronary heart disease and valvular heart disease. Factors that are in our control in order of importance are being overweight, drinking excessive alcohol (>15 units a week) or being unfit. Many of these factors are out of our control like getting older, or our genes. AF is a condition that can occur in any of us and there are factors that make it more likely to happen. The truth however is that it is a design flaw of the mammal heart and all large mammals can get AF. Many patients try to find reasons why their AF has started and look for things they do that may have initiated it.
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