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When treated correctly, atrial fibrillation generally has a good prognosis and patients can live a normal life.
In patients with no other diseases, recurrences of atrial fibrillation do not tend to escalate further. However, atrial fibrillation tends to exacerbate other heart diseases, when present, and leads to, for example, acute heart failure (generally a strong choking sensation) or angina (chest pain). A small proportion of patients with atrial fibrillation and ventricular pre-excitation (Wolff–Parkinson–White syndrome) may suffer potentially serious ventricular arrhythmias.
There are primarily two long-term complications of atrial fibrillation:
Thromboembolisms. The atrium’s inability to contract correctly means that blood begins to accumulate and eventually it coagulates to form small clots or thrombi. If these clots pass into the ventricle and later the aorta, they can be transported to and obstruct any artery in the body, resulting in an insufficient blood supply. If a thrombus develops in an artery in the brain, it will cause a stroke. If it develops in an arm or a leg, which is less common, or a coronary artery, then this will result in a heart attack. Not everybody with atrial fibrillation has the same risk of suffering a stroke. Less than 1 in every 100 patients with low-risk atrial fibrillation will endure a stroke each year. Of those with a high risk, more than 10 in every 100 will suffer a stroke each year. The healthcare team will assess the risk based on certain characteristics such as age, the presence of high blood pressure or other heart diseases, or a prior history of having suffered a stroke. It is very important to emphasise that the need to receive anticoagulant therapy does not depend on the number of episodes, their duration or whether each patient currently has atrial fibrillation.
Heart failure. Heart failure is a weakening of the heart. In some cases where atrial fibrillation results in an increased heart rate for extended periods, generally weeks, then this situation can weaken the heart. This weakening is usually reversible so long as the heart rate can be reduced, thereby re-establishing normal heart function.