A type of atrial fibrillation, known as familial atrial fibrillation, involves a genetic aspect. This means some people may be at a higher risk of atrial fibrillation due to hereditary factors.

Atrial fibrillation, or A-fib, refers to a type of arrhythmia, or irregular heartbeat. It occurs due to the irregular beating of the atrial chambers of the heart and often involves tachycardia, an unusually fast heartbeat. Instead of producing a single, strong contraction, the atrial chambers fibrillate, or quiver, which can result in a rapid heartbeat. If left untreated, it can result in heart failure.

There are different types of A-fib. Familial atrial fibrillation describes a type that is hereditary, which means it is capable of running in families. Evidence highlights some genetic changes that relate to the condition. With further research, screening tests may be able to identify these genes and provide individuals at risk with suitable treatment strategies.

This article discusses the genetic risk factors for atrial fibrillation alongside diagnostic and treatment options.

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Familial atrial fibrillation describes an inherited heart condition that can disrupt the heart’s rhythm. An individual may inherit certain gene alterations that may put them at a higher risk of developing the condition. A-fib occurs when there is erratic electrical activity in the atria — the upper chambers of the heart. This results in an irregular response in the lower chambers of the heart called the ventricles, leading to a fast and irregular heartbeat.

A-fib is the most common type of arrhythmia and may afffect 12.1 million people in the United States in 2030. Currently, the exact incidence of the familial form is unknown. However, some evidence suggests that up to 30% of people with A-fib without an identified cause have a family history of the condition.

Certain genes may cause A-fib on their own, while other genes may play an epigenetic role. This refers to how certain behaviors and the environment can cause changes that affect the way genes work.

Typically, alterations in these genes impact ion channels in the heart, which maintain the heart’s usual rhythm, or the structure of the heart, which can affect cardiac muscle contractions. However, in many cases, the exact cause is unclear and more research is necessary to clarify the role of genetic factors in the development of familial A-fib.

Some evidence highlights at least 138 genetic loci could play a role in the development of A-fib. Some of these include:

A person typically inherits gene changes that can lead to A-fib in an autosomal dominant pattern. This means that familial A-fib can occur when a child inherits one copy of a gene alteration from a biological parent. As such, this means that a child whose parent has the condition has a 50% chance of inheriting the gene change and potentially developing familial A-fib. In some cases, the condition may not have a clear autosomal dominant inheritance pattern.

In addition to a family history of the condition, individuals with one or more of the following risk factors are at a higher risk of A-fib. Risk factors can include:

Some people may not experience symptoms or may not notice any symptoms of A-fib. Others may have one or more of the following symptoms:

Additionally, A-fib may present differently in different people. For example, it may be occasional, only lasting for a few minutes or hours, or it can be persistent.

The characteristic symptoms of A-fib are fluttering and palpitations. If a person notices these symptoms, it is advisable for them to contact a doctor. However, many heart issues may present with similar warning signs. As such, it is important that a person receives emergency medical support if they suspect a heart attack.

A healthcare professional can diagnose A-fib through medical and family history, a physical exam, and certain tests and procedures. Initially, a doctor will ask a person questions about their symptoms and history. Next, they will perform an exam to assess their heart and lung health. This can involve checking the pulse, listening to the rhythm of the heartbeat, and measuring blood pressure.

After, a healthcare professional may request some diagnostic tests. Typically, they will start with an electrocardiogram (EKG) to record the electrical activity of the heart. If more information is necessary, a doctor may also request blood tests to measure for substances in the blood, or an echocardiogram to determine if areas of the heart muscle are not contracting properly.

A doctor may also suggest other tests to help differentiate A-fib from other types of arrhythmia. These can include:

Advancements in genetics may mean that clinicians could use genetic testing to identify high risk individuals. With further understanding of the role these genes play in the development of A-fib, they could also use this information to help guide treatment strategies. For example, in a 2021 study, genetic testing identified a gene variant in 10% of people with early-onset A-fib.

Treatment options for A-fib aim to prevent blood clots, slow the heartbeat, and restore the heart’s usual rhythm. These can include:

A doctor may also treat a person for an underlying health condition, such as obesity, sleep apnea, or hyperthyroidism, that could raise the risk of A-fib. After a diagnosis of A-fib, the American Heart Association (AHA) suggests the following tips to reduce the risk of potential complications:

  • rhythm control to help restore usual heart rhythm
  • rate control to reduce high heart rates
  • preventing blood clots
  • managing risk factors for stroke
  • preventing additional heart rhythm issues
  • preventing heart failure

Evidence highlights a genetic element that can influence a person’s risk of developing atrial fibrillation, which causes an irregular heartbeat. People can inherit genes from their biological parents that may impact the structure or electrical activity of the heart and disrupt its rhythm.

With further research and understanding of the role that these gene changes play in A-fib, health experts may be able to perform genetic screening tests to identify at-risk individuals and provide suitable treatment to prevent the condition.