Is atrial fibrillation a serious arrhythmia?

Written by Xie Zhi Hong
Cardiology
Updated on April 04, 2025
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Atrial fibrillation is a type of cardiac arrhythmia, primarily feared for its potential to form blood clots within the heart. These clots can travel to other organs via the bloodstream, most commonly to the brain. Additionally, pieces of these clots can also travel to coronary arteries causing myocardial infarction, leading to organ embolism wherever they lodge. Generally, if no blood clots are formed, many individuals with atrial fibrillation may not experience symptoms. However, if combined with other cardiac conditions such as heart failure or coronary artery disease, atrial fibrillation can exacerbate the risk of developing these heart diseases. Thus, atrial fibrillation on its own is not severe but becomes concerning when associated with other cardiac conditions, increasing the risk of other heart diseases. If atrial fibrillation occurs with left or right accessory pathways, it may also lead to ventricular fibrillation, resulting in sudden death of the patient. Moreover, if the atrial fibrillation has no apparent cause, and the heart structure is normal with no symptoms, then such isolated atrial fibrillation does not typically form blood clots and is considered relatively mild.

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How to relieve arrhythmia

The relief of arrhythmia mainly involves removing any triggers if they exist, as well as using non-pharmacological methods, including ocular compression, carotid sinus massage, pinching the nose and forcefully exhaling, and breath-holding, which are methods to reflexively stimulate the vagus nerve. If relief is unachievable and the episodes are accompanied by hypotension, fainting or near-fainting, seizures, angina, or heart failure, it is crucial to seek medical attention promptly for pharmacological interventions against arrhythmias, or even consider electrical treatments such as cardioversion, defibrillation, pacemaker implantation, and ablation, as well as surgical options.

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Arrhythmia is caused by what?

Arrhythmia is caused by abnormal excitation of the sinoatrial node or excitation originating outside the sinoatrial node, with slow conduction, blockage, or conduction through abnormal pathways. This results in the frequency and (or) rhythm abnormalities of heartbeats, which are collectively referred to as arrhythmias. Most of the causes include the following: one is genetic arrhythmias, often due to gene channel mutations, such as the commonly seen long QT syndrome, short QT syndrome, Brugada syndrome, etc. There are also acquired arrhythmias, seen in various organic heart diseases, including coronary atherosclerotic heart disease, commonly referred to as coronary heart disease, cardiomyopathy, myocarditis, and rheumatic heart disease, particularly prevalent during heart failure or acute myocardial infarction. Arrhythmias are also not uncommon in basically healthy individuals or patients with autonomic dysfunction. Other causes include electrolyte imbalance or endocrine disorders, and sometimes anesthesia, hypothermia, or surgery, such as thoracic or cardiac surgery, or medications, central nervous system diseases may also cause arrhythmias, but the specific reasons are not very clear.

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How to alleviate arrhythmia

Arrhythmia is very common in clinical settings, and its treatment mainly includes etiological treatment and symptomatic treatment. If a patient experiences occasional premature beats without significant hemodynamic effects, special treatment may not be necessary at this time. However, if a patient repeatedly experiences supraventricular tachycardia, atrial fibrillation, and other arrhythmias, cardiac electrophysiological examination and dynamic heart rate monitoring should be conducted. Antiarrhythmic drugs or even radiofrequency ablation may be administered for symptomatic treatment, as uncontrolled arrhythmias can easily lead to sudden death in patients.

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Do arrhythmias need treatment?

The treatment of arrhythmias should be based on the symptoms of the patient, the type of arrhythmia, and its impact on hemodynamics to determine if treatment is necessary. For instance, mild sinus bradycardia, irregular sinus rhythm, occasional atrial premature contractions, and first-degree atrioventricular block have minimal impact on hemodynamics. Therefore, if there are no obvious clinical symptoms and no cardiac structural disease, temporary drug treatment may not be required. However, severe arrhythmias such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and persistent ventricular tachycardia can cause palpitations, chest tightness, dizziness, low blood pressure, severe sweating, and in severe cases, syncope, Adams-Stokes syndrome, or even sudden death, which require immediate medical attention.

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What should be paid attention to in daily life with arrhythmia?

For managing arrhythmias, it's important to pay attention to several aspects. First, maintain a regular lifestyle and ensure adequate sleep. Second, the living environment should be quiet and serene to avoid noise, and it’s beneficial to grow various plants for a better temperament. Third, balance work and rest according to personal capacities and engage in appropriate physical activities such as walking, Tai Chi, and Qigong; moderate sexual activities and avoid colds. Fourth, strive to maintain a standard weight and not indulge in overeating, as obesity can increase cardiac load. Fifth, be mindful of changes in seasons, weather, and climate, as extreme cold or hot conditions can significantly impact the disease, potentially aggravating or triggering arrhythmias. Sixth, diet should be light with frequent, small meals, and avoid coffee, strong alcohol, fried foods, and minimise strong tea. Seventh, keep a stable emotional state and try to eliminate stress, fear, anxiety, irritation, and anger which are stimulants that could negatively affect your emotions. Eighth, in addition to daily medications, have emergency medications prescribed by a doctor on hand, such as Xintiandan, Shexiang Baoxin Pill, Xintongding, Atropine, etc. Ninth, if there are sudden exacerbations of arrhythmia accompanied by palpitations, chest tightness, dizziness, low blood pressure, and sweating, and in severe cases fainting, seek medical attention promptly.