What is Atrial Fibrillation Pathophysiology?

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  • Written By: J.M. Willhite
  • Edited By: Heather Bailey
  • Last Modified Date: 27 September 2019
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Atrial fibrillation pathophysiology is the terminology used to describe the progression of physiological changes associated with a cardiac arrhythmia. Defined by a chaotic rhythm originating in the atria, or the heart's upper chambers, atrial fibrillation pathophysiology is initiated by a disruption in the heart's electrical impulses. Treatment administered for atrial fibrillation is based on re-establishing and maintaining the heart's natural rhythm with medication and, in some cases, surgery.

Proper heart function is essentially based on rhythm. Initiated and controlled by electrical impulses, the heart flexes and relaxes according to the signals it receives. When a disruption in electrical impulse occurs in the atria, the heart will quiver and not complete a full, forceful beat. To compensate for the interruption, the heart works harder resulting in an unsynchronized heart rhythm.

Atrial fibrillation pathophysiology may develop for a variety of reasons. Individuals with a congenital heart condition and those who have suffered a heart attack are generally considered at an increased risk for developing a chaotic rhythm. Other fibrillation causes may include lung disease, infection and the chronic use of stimulating substances, such as caffeine.


Depending on whether one’s condition is episodic or chronic, symptoms associated with atrial fibrillation may vary in intensity and presentation. It is not uncommon for some individuals with an unsynchronized heart rhythm to remain asymptomatic, meaning they experience no obvious symptoms. Those who experience chronic signs will generally notice a gradual worsening of symptoms with the progression of the atrial fibrillation pathophysiology.

Heart quivering is the most common initial sign of atrial fibrillation. Some people may describe the quivering as feeling like their heart is struggling to beat or fluttering. In some cases, if the heart quivering is persistent, individuals may feel weak or drained with little to no exertion. A lack of proper blood flow may induce feelings of faintness or lightheadedness. As symptoms worsen, chest discomfort accompanied by shortness of breath may develop.

Once an atrial fibrillation has been detected, re-establishing regular heart rhythm, also known as normal sinus rhythm, is the goal of treatment. Various diagnostic tests, including an electrocardiogram (ECG) performed to measure the electrical conductivity of the heart, may be used to determine the extent of the dysrhythmia, or unsynchronized heart rhythm. Depending on the severity of one’s condition, atrial fibrillation pathophysiology may result in compromised blood circulation that can significantly increase one’s risk for stroke. Prolonged dysrhythmia that is not treated in a timely or appropriate manner can weaken the heart muscle and eventually jeopardize heart health.

Atrial fibrillation pathophysiology frequently necessitates the administration of anti-arrhythmic and anticoagulant medications to restore normal sinus rhythm and prevent blood clots. Surgical procedures, including the use of electrical shock administered with the aid of anesthesia, may be utilized to treat dysrhythmias that do not respond to medication. Once a regular sinus rhythm has been re-established, anti-arrhythmic medications may be administered over the long term to maintain heart rhythm.


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