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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Arrhythmia refers to what?

Arrhythmia refers to the abnormal origination or conduction of impulses in the heart due to abnormal activation of the sinoatrial node, slow conduction, blockages, or passage through abnormal pathways, leading to abnormalities in the frequency and/or rhythm of the heartbeat. Arrhythmias are a significant group of cardiovascular diseases. They can occur alone or in conjunction with other cardiovascular diseases. The prognosis of arrhythmias depends on their causes, triggers, trends in progression, and whether they lead to severe hemodynamic disturbances, potentially causing sudden death or continuous impairment of heart function leading to heart failure.

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What is ventricular arrhythmia?

Ventricular arrhythmias mainly refer to disorders of the ventricular rhythm and are relatively common clinically, including premature ventricular contractions, ventricular tachycardia, ventricular flutter, and ventricular fibrillation. Premature ventricular contractions generally do not cause noticeable clinical symptoms, while ventricular flutter and ventricular fibrillation are very dangerous clinically and must be treated promptly with defibrillation. Therefore, ventricular arrhythmias must be treated promptly, actively treating the underlying disease, and managing the arrhythmia to prevent sudden death.

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Causes of arrhythmia

There are many causes of arrhythmia, which can be physiological or pathological. Pathological causes can originate from the heart itself or from other diseases. For instance, normal individuals might experience sinus arrhythmia, and circumstances such as staying up late, emotional excitement, or excessive fatigue can lead to premature beats or sinus tachycardia, among others. Other diseases, such as hyperthyroidism or fever, can cause an increased heart rate. For example, pulmonary embolism can lead to atrial fibrillation. Heart-related diseases, like heart failure, can cause ventricular premature beats, and diseases of the sinoatrial node itself can lead to sick sinus syndrome, among others.

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Is arrhythmia very harmful?

Firstly, arrhythmias, whether supraventricular or ventricular, are harmful to the human body. However, ventricular arrhythmias tend to be more damaging. Supraventricular arrhythmias, including supraventricular tachycardia and atrial tachycardia, generally have a minimal impact on hemodynamics. However, they may still cause symptoms in patients such as palpitations, chest tightness, or even fatigue, a series of discomforting symptoms, but generally do not pose a life-threatening risk. However, ventricular arrhythmias are different, as they can cause disturbances in the body's hemodynamics, leading to ischemia and failure of various organs. Therefore, the harm they cause is significant, and they may even lead to sudden cardiac death. Hence, aggressive treatment and management of ventricular arrhythmias are necessary.

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Does arrhythmia require hospitalization?

Arrhythmia treatment should be determined based on the patient's symptoms, type of arrhythmia, and its impact on hemodynamics. For instance, minor conditions like slight sinus bradycardia, irregular sinus rhythm, occasional atrial premature contractions, and first-degree atrioventricular block, which have minimal impact on hemodynamics and no significant clinical manifestation or structural heart disease, do not necessitate hospitalization. However, more severe arrhythmias such as sick sinus syndrome, rapid atrial fibrillation, paroxysmal supraventricular tachycardia, and sustained ventricular tachycardia, which can cause symptoms like palpitations, chest tightness, dizziness, low blood pressure, sweating, and in severe cases, fainting, Adam-Stokes syndrome, and even sudden cardiac death, require prompt medical attention and hospitalization for treatment.