Can Atrial Fibrillation Go Away?

Atrial fibrillation is a medical condition that causes the heart to beat irregularly and rapidly.

Atrial fibrillation is a condition in which the heart beats irregularly and rapidly. During atrial fibrillation, the heart’s two upper chambers (the atria) beat irregularly without coordination with the two lower chambers (the ventricles) of the heart.

The symptoms of atrial fibrillation often include a feeling of racing or pounding heartbeat (palpitations), shortness of breath and weakness. Due to this irregular heart rate, patients may have an increased risk of severe heart and brain-related complications such as heart failure and brain stroke.

Atrial fibrillation is usually due to damage to the heart's electrical system from conditions such as longstanding uncontrolled high blood pressure and coronary artery disease (narrowing of the blood vessels, coronary arteries, that supply the heart). Atrial fibrillation is also the most common complication after heart surgery.

Below are a few common risk factors that can cause atrial fibrillation:

• The risk of atrial fibrillation increases with age.
• Patients with heart disease such as heart valve problems, congenital heart diseases (heart diseases since birth), heart failure, coronary artery disease, or a history of heart attack or heart surgery have an increased risk of atrial fibrillation.
• Patients with uncontrolled high blood pressure with a stressed lifestyle are at an increased risk of atrial fibrillation.
• Patients with severe health conditions such as thyroid problems, sleep apnea, diabetes, kidney disease, or lung disease are at an increased risk of atrial fibrillation.
• Patients who consume alcohol and smoke cigarettes are at a high risk of atrial fibrillation.
• Being overweight or obese increases the patient’s risk of atrial fibrillation. 
• A family history of heart disease or atrial fibrillation may also increase the risk of atrial fibrillation.

Atrial fibrillation can be classified into three different types:

• Paroxysmal atrial fibrillation: This type of atrial fibrillation can come randomly or suddenly. Symptoms may last for a few minutes or hours. The symptoms can begin anytime and include rapid heartbeat, breathlessness, anxiety, tiredness, and weakness that develop very quickly. Feeling physically exhausted is very common with this type of atrial fibrillation.
• Persistent atrial fibrillation: This type of atrial fibrillation lasts longer than seven days. Symptoms can be the same as those of paroxysmal atrial fibrillation. Treatment is needed with this type of atrial fibrillation because the heart rhythm doesn’t return to normal by itself.
• Long-standing persistent atrial fibrillation: It is longer lasting than even persistent atrial fibrillation and usually persists for at least 12 months. Usually, it requires extensive treatment such as pacemaker placement.

Usually, medications are the first and common choice of treatment for atrial fibrillation. Treatment options may include one or more of the following:

• Medications: Blood thinners and heart rate and rhythm controllers (aspirin, heparin, metoprolol, propafenone )
• Nonsurgical procedures: Electrical cardioversion (giving mild shock to the heart under sedation) and cardiac ablation (sending out electrical signals that destroy the cells causing irregular heartbeat)
• Surgical procedures: Open heart surgery with AV node (the bundle of excitable tissue that passes electrical signals from the atria to the ventricles) ablation and pacemaker placement.

Rarely, atrial fibrillation can go away on its own. Atrial fibrillation may be brief, with symptoms that come and go. It is possible to have an atrial fibrillation episode that resolves on its own or the condition may be persistent and require treatment. Paroxysmal atrial fibrillation is one of the types that starts suddenly and goes away own on its own. 

However, patients should still be monitored and treated. Usually, atrial fibrillation is permanent, and medicines or other nonsurgical treatments can't restore a completely normal heart rhythm. It is also important to maintain a heart-healthy lifestyle and reduce overall risks as much as possible.