Atrial fibrillation

What causes atrial fibrillation?

No-one can be sure what causes atrial fibrillation (AF). There are some factors, however, which may make people more susceptible.
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Yet, making sense of their diagnosis and identifying possible causes is important for many people. Elisabeth Y and Marianne believe that stress associated with the death of their husbands, ‘grief in its own country’, may have initiated their AF. Stress, anxiety, high blood pressure and a family history of heart problems were widely mentioned, with people often attributing their AF to more than one cause. Eileen is unsure what has triggered her AF but thinks it might be stress, although high blood pressure and a family history of AF and strokes could suggest a ‘genetic possibility as well’.
As well as high blood pressure, people also suggested other possible health links, including a history of mitral valve disease, reflux from a hiatus hernia, and an electrolyte imbalance. Chris X had heard theories about electrical defects and the shape of the heart wall, and suggested that endurance athletes can sometimes develop AF. Paul had trained in the military when he was younger, and had recently decided to train for a marathon. He wondered whether he had pushed his body too far and triggered AF.
Some people linked their AF to other health conditions, including the ‘vagal nervous system’ being out of balance and associated digestive issues, such as irritable bowel syndrome (IBS). Freda found that a lack of sleep affected her AF and that she had symptoms when her mind was ‘not active’. Anne had an enlarged heart due to another condition and wondered whether that had contributed to her developing AF. Dot said she did not know why her AF had started but was just ‘very annoyed about it’. Richard was told his AF might have been caused by rheumatic fever as a child, though he believes this is unlikely.
Some people found that their AF started after an operation and wonder whether there was a link. Jeni linked her AF to an operation on her womb, despite being reassured at the time that there was nothing wrong: ‘it’s quite common after surgery on the womb that women have palpitation attacks’.
Alcohol, smoking, coffee and being overweight were also suggested as possible causes of AF. As Nuala said, ‘I know that alcohol can have a big impact - when I look back on it now, I probably was taking far too much but I wasn’t aware of it at the time’. Dave, who has not had any alcohol for ‘nearly eighteen years’, accepts his consultant’s opinion that excess alcohol in the past may have contributed to his AF. Keith has now quit smoking but believes there may be a link between being a smoker in the past and his AF.
As well as trying to identify a primary cause for their AF, people also talked about their efforts to work out triggers which set off episodes of AF. In addition to factors such as stress, alcohol and caffeine (in coffee, tea, and cola drinks), people we interviewed mentioned changes in posture, for example lying down, having a coughing fit, anxiety, and eating a lot of heavy food or food with additives. 
(For more see ‘Reducing stroke risk through other medication and lifestyle changes after diagnosis of atrial fibrillation’)

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