Atrial Fibrillation

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Atrial Fibrillation
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Overview

Source: In partnership with Genetic and Rare Diseases Information Center, funded by the National Center for Advancing Translational Sciences, and the National Human Genome Research Institute https://rarediseases.info.nih.gov/gard.

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Familial atrial fibrillation

overview Question

What is familial atrial fibrillation?

Familial atrial fibrillation is an inherited heart condition that disrupts the heart's rhythm. It is characterized by erratic electrical activity in the heart's upper chambers (the atria), causing an irregular response in the heart's lower chambers (the ventricles). This causes a fast and irregular heartbeat (arrhythmia). Signs and symptoms may include dizziness, chest pain, palpitations, shortness of breath, or fainting. Affected people also have an increased risk of stroke and sudden death. While complications may occur at any age, some affected people never have associated health problems. Familial atrial fibrillation may be caused by changes (mutations) in any of various genes, some of which have not been identified. It is most often inherited in an autosomal dominant manner, but autosomal recessive inheritance has been reported.

Date Modified: 2015-11-09T09:48:00

basic Questions

How might familial atrial fibrillation be treated?

We are unaware of treatment recommendations specific to familial atrial fibrillation, but there is information available about treatment for atrial fibrillation in general.

Treatment for atrial fibrillation depends on the frequency and severity of symptoms and may involve medications, medical procedures, and lifestyle changes. People who don't have symptoms or related heart problems may not need treatment. The main goals of treatment include:

  • Preventing blot clots and lowering risk of stroke. This may involve blood-thinning medications such as warfarin, dabigatran, heparin, and aspirin.
  • Controlling the rate of contractions of the ventricles (rate control). This may involve medications to restore the heart rate to a normal level, such as beta blockers, calcium channel blockers, and digitalis.
  • Restoring a normal heart rhythm (rhythm control). This is typically for people who don't do well with rate control treatment, or for people who recently began having symptoms. Rhythm control may involve medications or procedures and is usually begun in a hospital for monitoring. Procedures may include cardioversion, catheter ablation, or maze surgery.

Date Modified: 2015-11-09T09:51:00

What is the long-term outlook for people with familial atrial fibrillation?

The long-term outlook (prognosis) for a person with familial atrial fibrillation (AF) varies depending on the type of atrial fibrillation the person has, as well as whether another underlying heart condition or disease is present. Generally, affected people can live normal, active lives, but ongoing medical care is important.While a person does not die from AF itself, a person can die from complications that result from having AF. The main risks in affected people are stroke and heart failure. AF is also associated with an increased risk of a first myocardial infarction (heart attack).

Many people with familial AF are said to have 'lone AF' - a term that describes AF in people younger than age 60 with no underlying heart disease. The prognosis is reportedly very good in people with lone AF. However, other cardiovascular risk factors, such as age, diabetes, hypertension, and prior stroke, can further increase the risk of stroke.

Other complications that may be associated with AF include adverse hemodynamics, reduced exercise tolerance, degraded quality of life, impaired cognition or dementia, and tachycardia-induced cardiomyopathy.

Generally, while there is conflicting evidence in younger people with no underlying heart abnormalities, AF is associated with reduced life expectancy in older affected people. In some cases, anti-arrhythmic drugs appear to contribute to increased mortality.

Date Modified: 2015-11-10T00:00:00

Presentation(s)

Thromboembolic stroke

Autosomal dominant inheritance

FDA Approved Medicines

  • FDA approved apixaban, sold as Eliquis, manufactured by Bristol-Myers Squibb for the prevention of stroke and systemic embolism resulting from nonvalvular atrial fibrillation ( Atrial Fibrillation ) in year 2011.
  • FDA approved dabigatran etexilate mesylate, sold as Pradaxa, manufactured by Boehringer Ingelheim for the risk reduction of stroke and embolism due to atrial fibrillation ( Atrial FibrillationStroke ) in year 2010.
  • FDA approved edoxaban, sold as Savaysa, manufactured by Daiichi Sankyo for the treatment of deep vein thrombosis, pulmonary embolism and risk of stroke and embolism due to atrial fibrillation ( Atrial Fibrillation | Deep Vein Thrombosis | Pulmonary Embolism | Stroke ) in year 2015.
  • FDA approved dronedarone, sold as Multaq, manufactured by Sanofi-aventis for the treatment of paroxysmal or persistent atrial fibrillation or atrial flutter ( Atrial Fibrillation | Atrial Flutter ) in year 2009.