Table of Contents

I. What is Atrial Fibrillation?

II. Symptoms of AFib

III. Variations of AFib

IV. Causes

V. Risk factors

VI. Diagnosis

VII. Treatment

VIII. FAQ: What Should I Do If I Think I Have Atrial Fibrillation?

What is Atrial Fibrillation?

AFib is the most common type of heart arrhythmia. It is also known as atrial fibrillation or AF. An arrhythmia occurs when the heart beats too slowly, too fast, or in an irregular way. By 2030, an estimated 12.1 million people in the United States are expected to have AFib. [1]

The heart is a complicated organ and requires seamless coordination of its chambers for it to beat correctly. When atrial fibrillation occurs, the heart’s two upper chambers (the atria) beat chaotically and out of coordination with the lower chambers (the ventricles). AFib can happen in brief episodes, and it may become permanent. [2] Read on to learn more about this condition and how it can be treated. 

Symptoms of AFib

Some people with AFib may not notice any symptoms and may be unaware they have the condition. [2] When symptoms do occur, they may include:

• An uneven or irregular heartbeat
• A racing, fluttering, or pounding sensation in the chest
• Dizziness or lightheadedness
• Severe tiredness
• Difficulty breathing
• Chest discomfort or pain [2]

Variations of AFib

Atrial fibrillation can be classified into several types based on how long it lasts and whether it stops on its own:

• Paroxysmal atrial fibrillation: Episodes occur within a seven-day period and often return to a normal rhythm without treatment.
• Persistent atrial fibrillation: Episodes continue for longer than seven days and usually require treatment to restore a normal heart rhythm.
• Long-standing persistent atrial fibrillation: The irregular heart rhythm continues without interruption for at least one year.
• Permanent atrial fibrillation: The condition remains long-term despite attempts to restore a normal rhythm. Treatment may still be used to manage symptoms and reduce the risk of stroke. [3]

Causes 

Atrial fibrillation can have several causes, but it often develops because of damage to the heart. [2] This damage may result from:

• High blood pressure
• Heart valve disease
• Congenital heart disease
• Pericarditis
• Cardiomyopathy
• Coronary heart disease
• Diabetes
• Living with obesity
• Having had surgery on your heart
• Stress
• Sick sinus syndrome [3]

Some people with atrial fibrillation may also experience atrial flutter. Atrial flutter causes the upper chambers of the heart to beat very quickly in a regular rhythm, while atrial fibrillation causes them to beat quickly and irregularly. People with atrial flutter may have periods of atrial flutter followed by periods of atrial fibrillation and may still be at risk of stroke or other heart conditions. [3]

Risk factors

As described above, numerous conditions can lead to the development of atrial fibrillation. Some risk factors of AFib can include: 

• Drinking alcohol: Drinking alcohol, particularly in large amounts over a short period, can weaken the heart muscle and reduce its ability to pump blood effectively. This may increase the likelihood of atrial fibrillation episodes. Alcohol can also contribute to dehydration, which may trigger AFib in some people. [4]
• Advanced age: The likelihood of developing AFib rises with age. High blood pressure, which also becomes more common as people get older, is linked to about one in five cases. [2] 
• Athletes: Endurance athletes may have a higher risk of developing atrial fibrillation because prolonged, vigorous exercise can lead to structural changes in the heart. [5]
• Underlying heart disease: Underlying heart conditions may also increase the risk, including heart valve disease, hypertrophic cardiomyopathy, coronary artery disease, a previous heart attack, and recent heart surgery. [6]
• Sleep apnea: Poor sleep, including sleep problems related to sleep apnea, may trigger episodes of atrial fibrillation. Even minor disruptions to sleep quality or duration may raise the risk of AFib by up to 18%, while people with insomnia may be up to 40% more likely to develop the condition. [4]

Diagnosis

To diagnose atrial fibrillation, your healthcare provider may use one or more tests to examine your heart and check for possible underlying causes.

• An electrocardiogram, or EKG, measures the heart’s electrical activity and can help identify an irregular rhythm. Information from a pacemaker or implanted defibrillator may also be reviewed. When an EKG does not provide enough information, your provider may recommend further testing.
• Blood tests can measure substances such as potassium and thyroid hormones. They may help identify factors contributing to atrial fibrillation and assess how well the liver and kidneys are functioning. These results can also help your provider choose an appropriate medication.
• An echocardiogram uses ultrasound to evaluate the heart valves, the size of the chambers, and how effectively the heart pumps. It may detect valve problems, areas of weakened heart muscle, previous damage caused by reduced blood flow, or blood clots inside the heart.
• Cardiac magnetic resonance imaging, or MRI, and other imaging tests may be used to examine the structure and function of the left atrium. These images can help assess the risk of complications, identify possible causes of atrial fibrillation, and guide treatment planning. [7]

Treatment

Treatment for atrial fibrillation depends on your symptoms, heart rate, stroke risk, and overall health. Your healthcare provider may prescribe medications to prevent blood clots or help return your heartbeat to a normal rhythm. If medication and lifestyle changes are not enough, a procedure may be recommended. Surgery is usually considered when a person is already having an operation for another heart condition, although it may sometimes be needed when other treatments have failed or during an emergency.

• Blood thinners, also called anticoagulants, help prevent blood clots and reduce the risk of stroke. These medications may include warfarin or direct-acting oral anticoagulants such as rivaroxaban. Because anticoagulants can increase the risk of bleeding, your provider will consider both the benefits and risks before prescribing them.
• Electrical cardioversion uses controlled, low-energy shocks to help restore a regular heart rhythm.
• Catheter ablation uses heat, cold, or another form of energy to destroy small areas of heart tissue that are causing abnormal electrical signals. The procedure may not permanently correct atrial fibrillation, and symptoms can return, particularly during the first few weeks afterward. Some people may need another ablation procedure. Although uncommon, possible complications include infection, bleeding, and stroke. A pacemaker may also be placed during the procedure if needed to keep the heart beating properly.
• A pacemaker may be used when atrial fibrillation occurs along with a slow heart rate or another electrical conduction problem, such as sick sinus syndrome. It is not usually used to treat atrial fibrillation on its own. People who receive a pacemaker may still need to take blood-thinning medication.
• The Maze procedure is a type of surgery that creates a pattern of scar tissue in the left atrium. These scars block abnormal electrical signals and help the heart maintain a regular rhythm. The procedure is generally performed during open-heart surgery for another condition, such as coronary heart disease or heart valve disease. [8] 

FAQ: What Should I Do If I Think I Have Atrial Fibrillation?

If you think you may have atrial fibrillation, contact your healthcare provider so they can check your heart rhythm and look for possible causes. AFib can cause symptoms such as a racing or irregular heartbeat, dizziness, fatigue, shortness of breath, or chest discomfort, but some people do not notice symptoms at all. Because AFib can increase the risk of blood clots and stroke, ongoing or repeated symptoms should not be ignored. 

Your provider may recommend tests such as an EKG, blood work, an echocardiogram, or heart imaging to confirm the diagnosis and guide treatment. If you are diagnosed with AFib, treatment may include medications to prevent blood clots, slow your heart rate, or help restore a normal rhythm. In some cases, procedures such as electrical cardioversion, catheter ablation, a pacemaker, or surgery may be considered depending on your symptoms and overall health. 

If you are concerned about AFib, take these steps:

1. Write down your symptoms, when they happen, how long they last, and what may trigger them.
2. Tell your provider about any risk factors, including high blood pressure, heart disease, sleep apnea, alcohol use, diabetes, or recent heart surgery.
3. Ask whether you need an EKG or other heart tests to confirm the rhythm problem.
4. Seek urgent medical care if you have chest pain, severe shortness of breath, fainting, sudden weakness, trouble speaking, or symptoms of a possible stroke.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.