The common disease atrial fibrillation explained

Atrial fibrillation is the most common cardiac arrhythmia. The atria no longer beat regularly, but too fast, too irregularly and too uncoordinatedly. This is often not an acute danger. However, if left untreated, atrial fibrillation can lead to a stroke.

According to the Swiss Heart Foundation, atrial fibrillation affects about one percent of the population in Switzerland, or about 100,000 people. Among people over 75, this figure is as high as ten percent. In atrial fibrillation, a large number of discharges occur, triggering an electrical "storm" in the atria. The many excitation circuits cause the atria to fibrillate and result in the ventricles also no longer being regularly excited. The picture of the Swiss Heart Foundation exemplifies these excitation circuits.

There are different types of atrial fibrillation. According to the Swiss Heart Foundation, these are divided into three groups according to frequency and duration:

paroxysmal atrial fibrillation

Atrial fibrillation occurs in attacks, lasts no longer than seven days and stops spontaneously

permanent atrial fibrillation

Atrial fibrillation remains present permanently. A normal rhythm cannot be achieved

persistent atrial fibrillation

Atrial fibrillation lasts longer than seven days and does not stop on its own. However, it can be converted to a normal rhythm with treatment.


What are the symptoms of atrial fibrillation?

A racing heart (palpitation) over several hours is the strongest symptom in many patients. But shortness of breath, fatigue or a feeling of pressure on the chest can also be symptoms of atrial fibrillation. However, atrial fibrillation can also trigger symptoms in quite a few patients. The earlier a cardiac arrhythmia is detected, the sooner treatment can begin, the disorder can be corrected, and a stroke can be prevented.

What causes atrial fibrillation?

The causes of atrial fibrillation are usually a result of aging and high blood pressure. Certain factors can promote atrial fibrillation such as existing heart disease, obesity, diabetes, hyperthyroidism, and alcohol use and cocaine. However, atrial fibrillation can also occur for no reason in heart-healthy individuals.

Diagnosis and treatment of atrial fibrillation

Diagnosis is made on the basis of an ECG measurement, such as evismo's CardioFlex long-term ECG service. According to the Swiss Heart Foundation, treatment of atrial fibrillation includes three possible measures:

  • Anticoagulation (blood thinning): To prevent clots from forming in the heart, most patients require blood-thinning medications

  • Rate control: Medications are used to lower the elevated heart rate, or pulse

  • Rhythm control: If symptoms are severe or heart failure develops, attempts are made to convert the atrial fibrillation to a normal sinus rhythm.

Recommendation on atrial fibrillation screening for all 65-year-olds

With demographic trends, atrial fibrillation is becoming increasingly important. The European Heart Rhythm Association (EHRA) has grouped digital cardiac rhythm devices in a simple overview in 2022 and derived recommendations for their use for early detection and application in cardiac arrhythmias. In doing so, EHRA also makes recommendations for broad atrial fibrillation screening for everyone over age 65.

Algorithms for the early detection of cardiac arrhythmias

To ensure that broad-based screening is possible at all and can be carried out cost-effectively, evismo and the iHomeLab of the Lucerne University of Applied Sciences and Arts have joined forces. WIth the support of Innosuisse, they are launching a project, in which algorithms are being developed that can detect cardiac arrhythmias in patients earlier and also predict them in the future.  

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