Atrial fibrillation – here are the risk factors and causes you should know about

People affected by describe it as having a diffuse start: the heart races, beats unevenly or feels "fluttering", sometimes accompanied by fatigue, shortness of breath or reduced energy. At the same time, there are other people who have not noticed anything at all  until a , a or an investigation of shows that the rhythm is not normal. It is precisely for this reason that knowledge about the risk factors and causes of atrial fibrillation is important to have. Some we cannot influence, such as age and heredity. But many of the other risk factors can actually be changed - for example, blood pressure, weight, drinking habits, sleep and other underlying diseases. Current guidelines clearly emphasize that the treatment of atrial fibrillation is not only about drugs and procedures, but also about finding and influencing the risk factors that lie behind and cause the condition.

Risk factors and causes you can – and cannot – influence

In atrial fibrillation, electrical signals occur in the atria of the heart that occur irregularly, causing the heart to beat rapidly and irregularly. It can cause symptoms, but it can also be silent. The important thing is that the condition not only affects quality of life, it also increases the risk of , and if it is not detected and treated.

Are there causes of atrial fibrillation that cannot be influenced?

Yes, there are several causes of atrial fibrillation that you unfortunately cannot fully control. These include, in particular:

• Older age – the risk increases significantly with age.

• Heredity – atrial fibrillation may occur more often in certain families.

• Congenital or structural heart defects – for example, valvular disease or previous heart surgery.

• Previous cardiovascular disease – such as heart attack, heart failure or coronary artery disease.

But this does not mean that the development of atrial fibrillation is “predestined” – on the contrary, modern healthcare shows that people with congenital vulnerability are often greatly influenced by factors that can be prevented and influenced, such as high blood pressure, obesity, alcohol or sleep apnea.

It is therefore possible to have a background risk – but still reduce the overall load on the heart.

What causes can be influenced?

Many conscious choices can be made in everyday life to reduce the risk of suffering from atrial fibrillation, here are 4 risk factors that you can actually prevent:

1. High blood pressure – this is one of the most important risk factors for atrial fibrillation. The heart is put under more strain when blood pressure is too high for a long time. The heart muscle and atria can change structurally, which makes the electrical signals more easily disrupted. Therefore, controlling blood pressure is a key factor, both in preventing atrial fibrillation and in reducing sequelae such as stroke and heart failure.

2. Overweight and obesity – these are also factors that increase the risk. Adipose tissue is not only a “storehouse” of energy, but also affects the body biologically through inflammation, hormonal signals and increased strain on the heart and blood vessels. Excess weight is also often associated with high blood pressure, insulin resistance, sleep apnea and poorer fitness – all of which are factors that together drive the risk of atrial fibrillation. Both European and American guidelines highlight weight loss and treatment of obesity as an important part of reducing the risk of suffering from atrial fibrillation.

3. Alcohol – this is another common and sometimes underestimated factor. Some people experience palpitations after even moderate amounts, while others only notice problems after they have reached a high consumption or after periods of more intense drinking. Alcohol can directly affect the heart's electrical signaling and at the same time impair sleep, blood pressure and recovery.

4. Smoking – Smoking is also mentioned in the international guidelines as a factor to be addressed. Smoking damages blood vessels and increases cardiovascular risk and often interacts with other stresses such as high blood pressure and lung disease.

It is relatively common for reality to look like this, you have slightly elevated blood pressure, are a few kilos overweight, snore a lot and drink alcohol on the weekends – without feeling "sick". All of these factors can together contribute to an increased risk over time. That is why a can be valuable even when you are feeling relatively well.

Other diseases that can cause or trigger atrial fibrillation

Atrial fibrillation often does not occur in isolation, it is a condition that often interacts with other diseases.

Common underlying conditions are:

• Coronary artery disease

• Valvular disease

• Lung disease

• Sleep apnea

• (hyperthyroidism)

Can stress cause atrial fibrillation?

The answer is that stress itself is rarely the only root cause, but it can act as a trigger in people who already have a vulnerability. The same applies to infection, fever, dehydration, lack of sleep and disturbances in the body's salts and minerals, so-called . If potassium, magnesium or other electrolytes are out of balance, the heart's conduction system can be affected. Certain medications, supplements and stimulants can also contribute in sensitive people.

Sleep apnea - often an undertreated cardiovascular risk factor

This condition deserves special attention. In obstructive sleep apnea, breathing stops repeatedly during sleep. This then leads to a lack of oxygen, stress on the body, increased blood pressure and increased strain on the heart. The American Heart Association has highlighted sleep apnea as an important and often undertreated cardiovascular risk factor, and screening is recommended especially in people with difficult-to-treat blood pressure or recurrent atrial fibrillation.

Hyperthyroidism – a classic example of a treatable cause

A classic example of a treatable cause of atrial fibrillation is an overactive thyroid gland (hyperthyroidism). If you have a high metabolism, the heart becomes more irritable and the pulse increases, which can trigger atrial fibrillation. Therefore, testing for is often included in the investigation. (nhs.uk)

Symptoms and warning signs

Atrial fibrillation can feel very different from person to person.

Common symptoms include:

• palpitations or irregular heartbeat

• rapid pulse

• shortness of breath

• fatigue or decreased energy

• dizziness

• chest discomfort

• reduced performance during exercise or work

Warning signs

It is also important to know that atrial fibrillation can also be completely asymptomatic. Some people only discover it when their blood pressure is checked, their pulse feels irregular, or when an ECG is taken before surgery, an occupational health check, or when investigating a stroke.

What can you do yourself – and when should you test your values?

The most effective preventive work is often about identifying what can be influenced early on. If you want to reduce your risk of atrial fibrillation, or have already been diagnosed, the following is especially important:

• control and treat high blood pressure

• work on weight loss if you are overweight or obese

• limit alcohol

• quit smoking

• treat diabetes, thyroid disease and other underlying diseases

• pay attention to symptoms of sleep apnea, such as snoring, breathing pauses and pronounced daytime fatigue

• prioritize regular physical activity and good sleep

Testing and <Link to="/halsokontroller/">health checks</Link> cannot diagnose atrial fibrillation alone – usually an ECG or rhythm recording is needed – but they can help to detect several of the underlying risk factors, such as blood pressure, blood sugar, blood lipids, kidney values ​​and thyroid tests.

It may be especially wise for people with fatigue, palpitations, high blood pressure or a history of cardiovascular disease to have a health check that also includes an ECG.

Knowing the risk factors and causes of atrial fibrillation is not just about understanding a diagnosis, but about having the opportunity to influence your future heart health. The earlier you find stress factors, the greater the chance of preventing complications.