What is Atrial Fibrilation (AFib)?

You're Not Alone in This Journey

If you or someone you love has been diagnosed with atrial fibrillation (AFib or AF), you might be feeling overwhelmed, scared, or confused. That’s completely normal. AFib affects millions of people worldwide – in fact, it’s the most common type of irregular heartbeat, which is a significant concern related to heart disease.

Anyone can develop AFib, but certain risk factors—such as age, high blood pressure, or underlying heart conditions—can make it more likely to develop AFib.

The good news? With the right knowledge and support, people with AFib can live full, active lives.

Understanding AFib in Simple Terms

Atrial fibrillation is when your heart’s upper chambers (atria) beat irregularly and often too fast, creating an irregular heart rhythm that is out of sync with your heart’s lower chambers (ventricles). The heart has four chambers—two upper chambers (atria) and two lower chambers (ventricles)—and AFib specifically affects the upper heart chambers.

Think of your heart like a well-coordinated dance team, as discussed by the heart rhythm society :

• Normal rhythm: All dancers move in perfect sync, creating a smooth, regular performance

• AFib: The lead dancers (your atria) are doing their own chaotic moves, throwing off the entire routine

Changes or damage to the heart's tissue can disrupt the electrical signals between the heart chambers and lead to AFib.

What's Actually Happening in Your Heart?

Your heart has its own electrical system that normally sends signals in a precise pattern:

1. Normally: Electrical signals start in your heart's natural pacemaker (SA node) → travel through the atria → pause at the AV node → continue to the ventricles

2. With AFib: Multiple chaotic electrical signals fire rapidly in the atria → the AV node gets overwhelmed trying to manage all these signals → your ventricles beat irregularly

This can cause your heart to beat anywhere from 100 to 175 times per minute (normal is 60-100 at rest).

What Does AFib Feel Like?

Everyone’s experience is different. Recognizing the symptoms of atrial fibrillation is important, as they can vary widely and help determine when to seek medical attention. Some people feel nothing at all, while others notice:

• Heart sensations: Racing, fluttering, pounding, or flip-flopping feelings in your chest

• Energy changes: Unusual tiredness, weakness, or inability to exercise like normal

• Breathing issues: Shortness of breath, especially during activities

• Other symptoms: Dizziness, lightheadedness, confusion, or chest discomfort

Important: Some people have no symptoms and only discover they have AFib during a routine checkup. This is why regular check-ups matter!

Types of AFib: Which One Do You Have?

Understanding your type helps you and your healthcare team create the best treatment plan.

Atrial fibrillation (AFib) is one of several types of arrhythmias. Another common arrhythmia is atrial flutter, which also involves the atria but is characterized by rapid, regular contractions, unlike the irregular rhythm seen in AFib. While both conditions can cause similar symptoms, their heart rhythm patterns and treatment approaches may differ.

Paroxysmal AFib (Occasional)

• Comes and goes on its own

• Episodes last less than 7 days (often less than 24 hours)

• May become more frequent over time

Persistent AFib

• Lasts longer than 7 days

• Usually needs treatment to restore normal rhythm

• Your heart won't return to normal rhythm on its own

Long-standing Persistent AFib

• Continuous AFib lasting more than 12 months

• You and your doctor have decided to try to restore normal rhythm

Permanent AFib

• Continuous and long-lasting

• You and your doctor have decided not to try to restore normal rhythm

• Focus shifts to controlling heart rate and preventing complications

Why AFib Matters: Understanding Your Risks

AFib itself usually isn’t life-threatening, but it can lead to serious complications if not properly managed. AFib increases the risk of stroke because the irregular heartbeat can disrupt blood flow in the heart, leading to the formation of blood clots.

Stroke

One of the most serious risks of AFib is stroke. The risk of stroke is primarily due to blood clots that can form in the heart and travel to the brain, blocking blood flow and causing an ischemic stroke.

Blood Clots and Stroke

• The biggest concern: When blood doesn’t flow properly through the atria, it can pool and form clots

• If a blood clot travels to your brain: It can cause a stroke

• Your risk: People with AFib are 5 times more likely to have a stroke

• The good news: Proper treatment can significantly reduce this risk

Heart-Related Complications

• Heart failure: Your heart may weaken from working too hard

• Other heart rhythm problems: AFib can trigger additional irregular heartbeats

• Cardiomyopathy: Long-term rapid heart rate can weaken the heart muscle

What Causes AFib?

Sometimes AFib happens without a clear cause, but common triggers and risk factors include:

Managing other health conditions that may contribute to AFib is also important for controlling symptoms and reducing the risk of complications.

Heart-Related Causes

• High blood pressure (most common)

• Heart valve problems

• Coronary artery disease

• Previous heart attack or heart surgery

• Congenital heart defects

Other Medical Conditions

• Overactive thyroid (hyperthyroidism)

• Sleep apnea

• Diabetes

• Chronic kidney disease

• Lung diseases

Lifestyle Factors

• Excessive alcohol ("holiday heart syndrome")

• Extreme stress or fatigue

• Caffeine (in sensitive individuals)

• Certain medications or stimulants

Risk Factors You Can't Change

• Age: Risk increases as you get older

• Family history: Genetics play a role

• Gender: More common in men, though women have higher stroke risk

How is AFib Diagnosed?

Getting an accurate diagnosis is the first step toward managing atrial fibrillation (AFib) and protecting your heart health. Your healthcare team will start by gathering a detailed medical history, asking about your symptoms, family history, and any risk factors like high blood pressure or heart disease. They’ll also perform a physical exam to check for signs of an irregular heartbeat or pounding heartbeat.

To confirm atrial fibrillation afib and understand its impact, your doctor will use a variety of tests that look at your heart’s electrical activity and overall function. These tests help pinpoint the type of AFib you have and guide your treatment plan.

Tests and Tools Your Doctor May Use

Diagnosing AFib often involves several specialized tools and tests, each providing important information about your heart:

• Electrocardiogram (ECG or EKG): This quick, painless test records your heart’s electrical activity and is the most common way to detect an irregular heart rhythm.

• Holter monitors: Worn for 24-48 hours, these portable devices track your heart’s rhythm over time, making it easier to catch intermittent episodes of AFib.

• Event monitors: Used for up to 30 days, these small devices help capture sporadic AFib episodes that might not show up during a standard ECG.

• Echocardiograms: Using ultrasound, this test creates images of your heart’s structure and function, helping your doctor spot issues like blood clots, coronary artery disease, or chronic kidney disease.

• Blood tests: These check for underlying health problems—such as high blood pressure, thyroid issues, or kidney disease—that could contribute to AFib or increase your risk of complications.

All these tools work together to help your healthcare team diagnose afib accurately and tailor your care.

What to Expect During Diagnosis

When you visit your doctor for AFib concerns, here’s what you can expect:

• Medical history review: Your doctor will ask about your symptoms, family history, and any risk factors like high blood pressure, heart disease, or previous episodes of chest pain and extreme fatigue.

• Physical examination: They’ll listen to your heart for signs of an irregular heartbeat or pounding heartbeat and check for other symptoms.

• Discussion of symptoms: Be prepared to talk about any episodes of shortness of breath, chest pain, or extreme fatigue you’ve experienced.

• Diagnostic tests: Your doctor will explain which tests are needed, such as ECG, echocardiogram, or blood tests, and how they help detect blood clots or other complications.

• Treatment plan review: Once AFib is confirmed, your healthcare team will discuss your options for atrial fibrillation treatment. This may include blood thinners to prevent blood clots, electrical cardioversion to restore normal rhythm, or catheter ablation for more persistent cases.

By working closely with your healthcare team and following your personalized treatment plan, you can take important steps to prevent blood clots and manage your AFib effectively.

AFib and Other Heart Conditions

Atrial fibrillation often doesn’t occur in isolation. Many people with AFib also have other heart conditions, which can increase the risk of heart failure, stroke, and other heart related complications. When AFib is combined with issues like heart valve disease or previous heart attacks, it can make managing your heart health more complex. That’s why it’s so important to work with your healthcare team to monitor for other heart related complications and keep your heart functioning at its best.

Heart Disease and AFib: The Connection

There’s a strong link between heart disease and atrial fibrillation. Conditions such as coronary artery disease, heart valve problems, and cardiomyopathy can raise your chances of developing AFib. At the same time, having AFib can make existing heart disease worse, increasing your risk for heart failure, ischemic heart disease, and stroke.

Managing both AFib and any underlying heart conditions is key to reducing your risk of blood clots and other complications. Following a healthy lifestyle—like eating well, staying active, and controlling high blood pressure—can help protect your heart rhythm and lower your stroke risk. Trusted organizations like the Heart Rhythm Society and the American Heart Association offer valuable resources and guidelines to help you prevent blood clots, maintain a healthy heart rhythm, and reduce your risk of higher risk complications.

By understanding the connection between AFib and heart disease, you can take proactive steps to safeguard your health and enjoy a better quality of life.

Taking Control: Your Next Steps

1. Build Your Healthcare Team

You’ll likely work with your health care team, which may include:

• Your primary care doctor

• A cardiologist (heart specialist)

• Possibly an electrophysiologist (heart rhythm specialist)

Your health care team plays a key role in managing AFib, assessing your stroke risk, and guiding treatment decisions.

2. Key Questions for Your Doctor

• What type of AFib do I have?

• What's causing my AFib?

• What's my stroke risk?

• What are my treatment options?

• How will AFib affect my daily life?

• What symptoms should prompt immediate medical attention?

3. Emergency Warning Signs

Call 911 immediately if you experience:

• Chest pain or pressure

• Severe shortness of breath

• Signs of stroke (F.A.S.T.):

  • Face drooping

  • Arm weakness

  • Speech difficulty

  • Time to call 911

Living Well with AFib

Remember, an AFib diagnosis doesn't mean your life is over – it means your life is different. Thousands of people with AFib are living full, active lives, despite experiencing various afib symptoms . They're traveling, exercising, working, and enjoying time with loved ones. With proper management, you can too.

You've Already Taken the First Step

By learning about your condition, you're empowering yourself to be an active participant in your care. Knowledge truly is power when it comes to managing AFib, as emphasized by the american heart association .