Atrial Fibrilation
Symptoms
Diagnosis
Management
Prevention
What to Expect
Living Well
Your heart normally beats in a steady, coordinated rhythm. With atrial fibrillation, the upper chambers of your heart (called atria) beat irregularly and often too fast. Instead of pumping blood efficiently, these chambers quiver or “fibrillate,” which can make you feel like your heart is racing, fluttering, or skipping beats.
Atrial fibrillation affects more than 6 million people in the United States, and this number continues to grow as the population ages. While AFib itself isn’t usually life-threatening, it can lead to serious complications like stroke or heart failure if left untreated.
The good news is that with proper medical care and lifestyle changes, most people with AFib can manage their condition successfully and maintain their quality of life.
Atrial fibrillation occurs when the electrical signals in your heart become chaotic. Normally, your heart’s natural pacemaker sends regular electrical impulses that coordinate your heartbeat. In AFib, multiple areas in the upper chambers fire electrical signals at the same time, creating an irregular, often rapid rhythm.
This condition becomes more common with age, affecting about 9% of people over 65. However, AFib can occur at any age and sometimes affects people with otherwise healthy hearts. The condition may come and go (paroxysmal AFib) or be persistent or permanent.
AFib matters because it affects how well your heart pumps blood throughout your body. When the upper chambers don’t contract properly, blood can pool and form clots. These clots can travel to your brain and cause a stroke — which is why AFib increases stroke risk by about five times. The irregular rhythm can also weaken your heart over time, leading to heart failure.
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Symptoms and Causes
Many people with AFib notice their heart beating differently, but symptoms can vary widely. Some people feel obvious symptoms, while others have no symptoms at all and only discover their AFib during a routine medical exam.
Common symptoms include:
Heart palpitations (feeling like your heart is racing, fluttering, or pounding)
Shortness of breath, especially during physical activity
Chest pain or pressure
Fatigue or weakness
Dizziness or lightheadedness
Confusion or difficulty concentrating
Common causes and risk factors:
Age: Risk doubles about every 10 years after age 55
High blood pressure: Major cause; enlarges the atria and strains the heart
Heart disease: Coronary artery disease, valve disease, or prior heart attacks
Other conditions: Diabetes, obesity, sleep apnea, thyroid disorders
Lifestyle factors: Heavy alcohol use, smoking, chronic stress
Family history: AFib sometimes runs in families, suggesting a genetic component
Diagnosis
Diagnosing AFib typically begins with your doctor listening to your heart and asking about symptoms. Because AFib can come and go, diagnosis often requires specific tests.
Key diagnostic tools:
Electrocardiogram (ECG/EKG): Detects irregular rhythm in minutes.
Holter monitor: Worn for 24–48 hours to record continuous heart activity.
Event monitor: Worn for weeks or months and activated when symptoms occur.
Smart devices: Some smartwatches can detect irregular rhythms, but medical confirmation is required.
Your doctor will also assess your overall heart health:
Blood tests: Check thyroid, kidney, and electrolyte levels.
Echocardiogram: Ultrasound to view heart structure and pumping strength.
These results help guide a personalized treatment plan.
Management and Treatment
AFib treatment focuses on three main goals:
Control your heart rate
Prevent blood clots
Restore normal rhythm (when possible)
Blood thinners (anticoagulants)
Prevent stroke by reducing clot formation.
Common options include:
Warfarin
Apixaban
Rivaroxaban
Dabigatran
Rate control medications:
Slow the heart to a normal range.
Beta-blockers (metoprolol, atenolol)
Calcium channel blockers (diltiazem, verapamil)
Digoxin (for select cases)
Rhythm control options:
Antiarrhythmic drugs to maintain a normal rhythm
Cardioversion (controlled electrical shocks) to reset rhythm
Catheter ablation to remove small areas causing irregular signals
The best approach depends on your age, symptoms, and health. Some do well with rate control; others benefit from restoring rhythm.
Prevention
While not all cases can be prevented, lifestyle plays a major role in reducing risk and preventing complications.
Preventive Steps
Maintain a healthy weight
Exercise regularly (moderate intensity, doctor-approved)
Manage blood pressure and cholesterol
Control diabetes and treat sleep apnea
Limit alcohol and quit smoking
Reduce stress and prioritize rest
For those already diagnosed:
Take medications exactly as prescribed
Attend regular follow-ups
Track triggers like caffeine, stress, or poor sleep
Healthy habits reduce the frequency and severity of AFib episodes.
Outlook
Your long-term outlook depends on age, heart health, and treatment response. With proper management, most people with AFib live full, active lives.
Positive outcomes are linked to:
Early diagnosis and treatment
Consistent use of blood thinners
Good blood pressure control
Lifestyle changes (weight, diet, exercise)
Risk reduction:
Blood thinners reduce stroke risk by 60–70%.
Heart failure risk decreases when rate control and underlying issues are well managed. Ongoing care and regular follow-up with your cardiologist ensure your treatment stays effective over time.
Living With Afib
Living with AFib means finding balance — managing your condition without letting it control your life.
Daily management:
Take medications consistently
Track symptoms and possible triggers
Keep emergency contacts and medical ID handy
Monitor your pulse and rhythm as advised
Activity and safety:
Stay active; most people can exercise safely
Avoid overexertion and listen to your body
Discuss exercise plans with your doctor
When to call your doctor:
Worsening chest pain or shortness of breath
Dizziness, fainting, or irregular heart rate
Signs of bleeding (if on blood thinners)
Take Control of Your Heart Health
If you’re experiencing symptoms of atrial fibrillation or have concerns about your heart rhythm, don’t wait to seek medical attention. Early diagnosis and proper treatment can help prevent complications and improve your quality of life.
References
American Heart Association. (2023). What is Atrial Fibrillation (AFib or AF)? heart.org
Mayo Clinic. (2023). Atrial fibrillation – Symptoms and causes. mayoclinic.org
January, C. T., et al. (2019). 2019 AHA/ACC/HRS Guideline Update for AFib Management. Circulation, 140(2): e125–e151.
Centers for Disease Control and Prevention. (2022). Atrial Fibrillation. cdc.gov
Hindricks, G., et al. (2020). ESC Guidelines for the Diagnosis and Management of Atrial Fibrillation. Eur Heart J, 42(5), 373–498.