Atrial fibrillation (also called Afib or AF) is an irregular heart rhythm (arrhythmia) that begins in the upper (atria) of your heart. If you have atrial fibrillation, the normal cycle of electrical impulses in your heart is interrupted. This leads to a fast, chaotic heart rhythm and poor movement of blood from your atria to your lower chambers (ventricles).
There are three main types of atrial fibrillation.
Paroxysmal Afib lasts less than one week and usually stops on its own without treatment. (Paroxysmal is pronounced par-?"k-??siz-m?"l.)
Persistent Afib lasts more than one week and needs treatment.
Long-standing persistent Afib lasts more than a year and is sometimes difficult to treat.
Afib, if untreated, can lead to a stroke and other serious medical complications. That’s why it’s important to learn the symptoms and talk with your healthcare provider about your personal risk factors.
What are the symptoms of atrial fibrillation?
You might be wondering what Afib feels like. Some people with Afib have no symptoms. It depends on how fast your ventricles are beating. If they’re beating at a normal or slightly elevated pace, you probably won’t feel anything. But if your ventricles beat faster then you’ll start to notice symptoms. These can include:
Blood thinners (anticoagulant medications) to reduce the risk of blood clots and stroke. Examples include warfarin, warfarin alternatives or aspirin.
Any medications can cause side effects. Rate control and rhythm control medications may make your arrhythmia worse or impact your lungs, liver or other organs. Blood thinners can cause bleeding, indigestion or a heart attack. Usually, the benefits of taking these medications outweigh your risk of side effects. It’s important to discuss all risks and side effects with your provider.
Procedures and surgeries
If medications don’t help your Afib, you may need a procedure or surgery.
Electrical cardioversion electrically “resets” your heart rhythm using low-energy shocks, but it may only be a temporary solution.
Pulmonary vein ablation uses catheters to deliver energy outside and around your pulmonary veins. This procedure helps you respond better to your Afib medications. You may not even need medications long-term.
A permanent pacemaker may be inserted if you have a slow heart rate. Usually, it’s only used if you have another arrhythmia in addition to Afib.
The MAZE procedure creates scar tissue that helps your heart’s electrical impulses travel in the right path. This procedure has a high success rate. If you have severe Afib symptoms and a history of stroke or blood clots, your provider may recommend this option.
Many procedures can be non-invasive, and newer treatment methods and technologies are constantly developing. Talk with your provider about the options that are best for you.
Can Afib go away?
If you have paroxysmal Afib, your symptoms may go away on their own without treatment. However, paroxysmal Afib can progress to persistent Afib depending on your risk factors. And both persistent Afib and long-standing persistent Afib require treatment to avoid serious complications. As Afib progresses, it becomes more serious and harder to treat. Afib can’t be cured, but its symptoms can be managed. Talk with your healthcare provider about the management and treatment plan that’s best for you.
How is atrial fibrillation diagnosed?
To diagnose atrial fibrillation, your healthcare provider will first ask you some questions. You’ll share information about your diet and physical activity, family history, any symptoms you’ve noticed and risk factors. It’s OK if you don’t know all the answers but share as much as you can. Your experiences and knowledge are essential tools to help your provider make a diagnosis. Your provider will then give you a physical exam that includes:
Listening to your heart rhythm with a stethoscope.
Checking the size of your thyroid gland to identify thyroid problems.
Looking for swelling in your feet or legs to identify heart failure.
Listening to your lungs to detect heart failure or infection.
This exam will help your provider understand your baseline health and how your body is functioning.
Tests to diagnose atrial fibrillation
In addition to the physical exam, your provider may run some tests to make an atrial fibrillation diagnosis. These tests include:
Electrocardiogram (EKG or ECG). An EKG is usually the first test. It’s painless and takes about three minutes. It measures and records your heart’s electrical signals and allows your provider to see if your heart is beating normally.
Echocardiogram (echo). An echo uses ultrasound technology to show your heart’s movement. It can reveal problems with blood flow and heart muscle contractions.
Blood tests. Sometimes, imbalances in our blood can cause Afib. Simple blood tests can show your potassium and thyroid hormone levels and can help your provider choose the best medicines for you based on your liver and kidney function.
In some cases, your provider may want to check how your heart works in your daily life. If so, you’ll be asked to wear a Holter monitor (for one or two days) or a portable event monitor (for up to one month) to record your heart’s activity.
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