Introduction to Atrial Fibrillation

What Causes Atrial Fibrillation?

In general, the causes of atrial fibrillation (AF) may be grouped into the following broad categories:

• Cardiovascular causes
• Metabolic causes
• Respiratory causes
• Lifestyle factors

Cardiovascular Causes

Atrial fibrillation may be precipitated by a variety of underlying cardiovascular disturbances including:

• Congestive heart failure
• Hypertension
• Ischemic heart disease
• Sick sinus syndrome
• Mitral stenosis
• Mitral regurgitation
• Aortic stenosis
• Congenital heart defects (particularly atrial-septal defect)
• Pericarditis
• Endocarditis
• Myocarditis
• Wolf-Parkinson-White syndrome
• Supraventricular arrhythmia
• Cardiomyopathy

Metabolic Causes

A variety of underlying metabolic disturbances may trigger atrial fibrillation including:

• Hyperthyroidism (particularly thyrotoxicosis)
• Sympathomimetic medications (e.g., albuterol, epinephrine, terbutaline)
• Low levels of potassium, magnesium, or calcium
• Pheochromocytoma

Respiratory Causes

In some cases, atrial fibrillation may occur as a result of an underlying respiratory problem including:

• Lung infection (e.g., pneumonia)
• Lung cancer
• Blood clot in the lungs (pulmonary embolism)
• Surgery involving the chest (e.g., coronary artery bypass surgery)

Lifestyle Factors

Certain lifestyle factors may precipitate atrial fibrillation including

• Alcohol abuse
• Excessive consumption of caffeine
• Drug abuse (e.g., cocaine)