Atrial Fibrillation (AFib)
Atrial fibrillation (AFib) is a heart rhythm condition in which the upper chambers of the heart beat irregularly and often too quickly. Instead of squeezing in a steady pattern, they quiver. This affects how blood moves through the heart.
AFib matters because it can increase the risk of stroke and heart failure. With proper treatment and follow-up, many people live full and active lives.
Types of Atrial Fibrillation
AFib does not look the same for everyone. Clinicians describe AFib based on how long episodes last and whether the rhythm returns to normal.
Common types include:
Paroxysmal AFib: Episodes come and go on their own. They usually stop within 7 days.
Persistent AFib: The irregular rhythm lasts longer than 7 days and may require treatment to restore normal rhythm.
Long-standing persistent AFib: AFib continues for more than 12 months.
Permanent AFib: The heart rhythm remains irregular, and you and your clinician decide not to attempt restoring a normal rhythm.
Symptoms
Some people notice clear symptoms. Others have no symptoms at all. AFib may be found during a routine exam.
Common symptoms include
Fluttering, racing, or irregular heartbeat
Feeling tired or low on energy
Shortness of breath, especially with activity
Dizziness or light-headedness
Chest discomfort
Feeling weak or less able to exercise
AFib itself is not usually an emergency. However, call 911 if you have:
Chest pain that does not go away
Trouble breathing
Signs of stroke, such as face drooping, arm weakness, or trouble speaking
Casues & Risk Factors
AFib develops when the heart’s electrical signals don't move in a steady, organized pattern. Certain conditions directly affect heart tissue, while others increase strain on the heart.
Causes
AFib occurs when abnormal electrical signals in the upper chambers disrupt the normal heartbeat. Instead of contracting in a coordinated way, the atria quiver. This can allow blood to pool inside the heart, which increases the risk of clot formation.
Direct causes often involve structural or electrical changes in the heart, such as:
Coronary artery disease
Heart valve disease
Heart failure
Scarring after heart surgery
Inflammation or infection affecting heart tissue
Risk Factors
Some factors increase the likelihood of developing AFib.
Modifiable risk factors
High blood pressure
Diabetes
Sleep apnea
Obesity
Excess alcohol use
Smoking
Physical inactivity
Non-modifiable risk factors
Older age
Family history of AFib
Certain genetic traits
AFib is more common in older adults and occurs more often in White adults, but it affects people of all backgrounds.
Diagnosis
Clinicians diagnose AFib using your medical history, a physical exam, and heart rhythm tests.
Common tests include:
Electrocardiogram (ECG or EKG): Records the heart’s electrical activity and can confirm an irregular rhythm
Heart monitor: A portable device worn for days or weeks to detect AFib that comes and goes
Echocardiogram: An ultrasound that shows heart structure and pumping function
Blood tests: Check thyroid function and other conditions that may trigger rhythm changes
AFib doesn't always occur constantly. Some people need extended monitoring before clinicians confirm the diagnosis.
Treatment
The goals of treatment are to control heart rate, maintain a steady rhythm when appropriate, reduce the risk of stroke, and address underlying risk factors. Not every person needs every treatment. Care depends on symptoms, overall health, and stroke risk.
Lifestyle Changes
Healthy habits support heart rhythm and reduce complications.
Managing blood pressure
Maintaining a healthy weight
Limiting alcohol
Treating sleep apnea
Staying physically active in safe ways
Even small changes can support heart health.
Medications
Medications may help:
Slow the heart rate
Maintain a regular rhythm
Reduce the risk of blood clots
Blood thinners reduce the risk of stroke by lowering the chance of clot formation. You may need a blood thinner even if you do not feel symptoms. Stroke risk depends on factors such as age, blood pressure, and other medical conditions, not just how AFib feels.
Procedures
Some people benefit from procedures if medications do not control symptoms.
Cardioversion: A controlled electrical treatment that restores normal rhythm
Catheter ablation: A procedure that targets small areas of heart tissue causing abnormal signals
Pacemaker: A device that helps regulate heart rhythm in certain situations
Procedures are not needed for everyone. Decisions depend on symptom severity and response to treatment.
Living WIth/Prevention
AFib is often a long-term condition. Ongoing care helps reduce complications and improve quality of life.
Regular follow-up visits allow clinicians to:
Monitor heart rhythm
Adjust medications
Assess stroke risk
Review side effects
Prevention focuses on managing underlying conditions and supporting heart health.
You can lower risk by:
Controlling blood pressure
Managing diabetes
Maintaining a healthy weight
Limiting alcohol
Avoiding tobacco
Staying physically active
Many people with AFib live full, active lives with proper treatment and monitoring.
Take Control of Your Heart Rhythm
If you have questions about atrial fibrillation or your stroke risk, talk with your clinician. Understanding your condition and staying engaged in your care can help you make informed decisions and protect your long-term heart health.
References
American Heart Association. What are the symptoms of atrial fibrillation? Accessed December 6, 2025.
American Heart Association. What is atrial fibrillation? Accessed February 6, 2025.
Chung MK, Eckhardt LL, Chen LY, et al. Lifestyle and risk factor modification for reduction of atrial fibrillation: a scientific statement from the American Heart Association. Circulation. 2020;141(16). https://doi.org/10.1161/CIR.0000000000000748. Accessed February 6, 2025.
Joglar JA, Chung MK, Armbruster LA, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. JACC. 2023;83(1). Published November 30, 2023. doi:10.1016/j.jacc.2023.09.017.
National Heart, Lung, and Blood Institute. Atrial fibrillation: causes and risk factors. Accessed December 6, 2025.
National Heart, Lung, and Blood Institute. Atrial fibrillation: diagnosis. Accessed February 6, 2025.
National Heart, Lung, and Blood Institute.Atrial fibrillation: types.NHLBI. Accessed December 6, 2025.
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