How to Identify Atrial Fibrillation (AFib)

Along With Helpful Treatment Options

Medically reviewed by Anthony Pearson, MD

Atrial fibrillation, often called AFib, causes an irregular and sometimes rapid heartbeat. It ranks as one of the most common arrhythmias (irregular heart rhythms). AFib affects more than 5 million U.S. adults.

AFib can occur with or without symptoms. Untreated AFib raises your risk of blood clots, stroke, heart attack, and heart failure. Treating the problem can prevent these dangers and let you live a normal and active life.

This article describes atrial fibrillation symptoms, diagnosis, and treatment. It also tells you which symptoms are serious and need urgent care.

AFib Meaning & Changes to Heart Rate

Atrial fibrillation occurs when irregular electrical signals in your heart's atria (the two upper cardiac chambers) disrupt the normal beating of your heart. The problem prevents blood from flowing normally to the ventricles (the two bottom cardiac chambers).

When this happens, the chambers don't work together to pump blood to your lungs and the rest of your body. The effect can leave you feeling tired or dizzy.

When not enough blood is pumped from your atria, the blood may pool there. This increases your risk of blood clots and stroke. It can also cause or worsen other types of heart disease.

Without treatment, AFib episodes can occur more often and last longer. The problem can weaken your heart and increase your stroke or heart failure risk.

Who Gets Atrial Fibrillation?

Atrial fibrillation can occur due to changes in your heart's structure. You have a higher risk of these types of changes and getting atrial fibrillation if the following factors pertain to you:

• Age 65 or older

• Family history of atrial fibrillation

• Being White and of European ancestry

• Previous surgery on your heart, lungs, or esophagus (food tube)

• Regularly consuming large amounts of alcohol, especially binge drinking

• Recreational drug use

• Smoking

• Participating in physically demanding activities like endurance sports

• Having obesity or a higher than average body weight

• Sleep apnea and other sleep disorders

• Diabetes

• High blood pressure (hypertension) and other types of heart disease
  

AFib Symptoms

AFib symptoms can vary by individual. Some people have atrial fibrillation without symptoms. Symptoms can also vary by type of disease.

There are different types of AFib, some of which are similar but differ in duration and the underlying causes. AFib is classified according to the following categories:

• Paroxysmal fibrillation: Episodes of AFib that occur unpredictably and resolve on their own or with treatment within seven days of an abnormal heart rhythm

• Persistent AFib: Episodes of AFib that last longer than seven days and require treatment to return to a normal heart rate

• Long-standing persistent AfFb: AFib that is consistent and lasts longer than 12 months

• Permanent AFib: A term that indicates that the patient and their provider have decided to forego treatment

Newer Afib guidelines emphasize that AFib occurs on a continuum and defines it according to various stages. Stage 1 means a person has risk factors. Stage 2 is when electrical abnormalities have developed in the heart but not yet led to symptomatic AFib. Stage 3 encompasses paroxysmal, persistent, and long-standing AFib. Permanent AFib is called Stage 4.

Symptoms That Come and Go

When symptoms occur during an episode of atrial fibrillation, they can include the following:

• Fluttering, quivering, or thumping heartbeat

• Rapid and irregular heartbeat

• General fatigue or lack of energy
  

• Shortness of breath and anxiety

• Weakness

• Dizziness, faintness, or confusion

• Sweating

• Fatigue when exercising
  

• Chest pain, pressure, or another chest discomfort (a medical emergency that may be a sign of a heart attack)
  

Long-term Symptoms

Long-term atrial fibrillation symptoms can occur because your heart is not pumping as efficiently as it should. This can affect your functional status, reducing your ability to perform daily activities. These symptoms include the following:

• Reduction in exercise tolerance

• Dyspnea (labored breathing)

• Chronic fatigue

• Chest pain

• Dizziness

Learn More: Symptoms of Atrial Fibrillation

When Should You Worry About AFib Symptoms?

Your healthcare provider can advise you when AFib symptoms are a cause for concern. Consult your healthcare provider if you have any of the following symptoms that are common with atrial fibrillation:

• A heartbeat that is significantly faster or slower than 60 to 100 beats per minute (the average heart rate for most adults)

• A feeling of tiredness or fatigue that is worse than normal

• Inability to complete a regular exercise routine
  

When AFib Requires Emergency Care

Some AFib episodes require emergency care. Contact your healthcare provider if your AFib episode lasts 24 to 48 hours without stopping or if symptoms worsen. Call 911 or go to an emergency room if you have any of the following symptoms:

• Sudden weakness or numbness

• Difficulty speaking or seeing

• Passing out or feeling like you're going to pass out

• Significant shortness of breath

• Severe light-headedness

• Cold or clammy sensation

• Chest pain that persists longer than five to 10 minutes without an AFib episode (may indicate a heart attack)

Dangers of Untreated Atrial Fibrillation

Untreated atrial fibrillation often causes your heart to beat rapidly and less efficiently. The effect can weaken your heart and reduce its ability to pump blood. The most serious complications of untreated AFib include the following:

• Blood clots

• Stroke due to blood clots that travel to your brain

• Congestive heart failure (inability of your heart to pump enough blood for your body's needs)

• Chronic fatigue

• Other heart rhythm problems like a rapid ventricular response (RVR)

• Inconsistent blood supply to the rest of your body

AFib With Rapid Ventricular Response (RVR)

Rapid ventricular rate (RVR) is a complication of atrial fibrillation that affects the rate at which your ventricles (two lower chambers of your heart) contract. This rate of contraction defines your heart rate.

AFib causes the atria to generate erratic electrical signals that cause a rapid beat. When these signals are sent to your ventricles, they may or may not cause symptoms.

AFib with RVR describes a condition in which the ventricles respond by beating irregularly, causing a rapid heart rate.

Testing to Diagnose Atrial Fibrillation

Testing to diagnose atrial fibrillation confirms the cause of an irregular heartbeat so you can begin treatment and reduce your risk of serious health threats. To make a diagnosis, your healthcare provider uses one or more of the following procedures:

• Physical exam: Your physical exam includes a complete medical and family history, a discussion of your symptoms, and listening for an irregular heartbeat through a stethoscope.
  

• Electrocardiogram (ECG/EKG): An ECG uses electrodes attached to your chest, arms, and legs to measure the rate and rhythm of your heart. It is usually the first and definitive test used to diagnose atrial fibrillation because it can identify an arrhythmia.

• Holter monitor: A Holter monitor is a portable, wearable ECG that records your heart's activity over several days. Other portable monitors, called event monitors, can record your heart's activity for longer periods.
  

Learn More: How Fitness Trackers Can Help Reduce Afib and Stroke Risk

AFib Treatment

AFib treatment includes several different approaches. Treatment can involve medication, devices, and/or surgery. The method of treatment you receive depends on factors such as the type of atrial fibrillation you have, your treatment goals, age, and other medical conditions.

Medication

Medication can be used to prevent blood clots, slow your heart rate, or restore your heart's normal rhythm. Medications commonly used to treat atrial fibrillation include the following:

Beta-blockers: These medications slow the rate at which your ventricles pump blood throughout your body. Commonly used beta-blockers for atrial fibrillation include:

• Coreg (carvedilol)

• Inderal LA (propranolol)

• Tenormin (atenolol)

• Toprol XL (metoprolol)

• Zebeta or Ziac (bisoprolol)
  

Calcium channel blockers: These medications reduce the amount of calcium that flows to your heart muscle cells and the cell walls of your arteries. They include the following:

• Cardizem (diltiazem)

• Verelan (verapamil)

Antiarrhythmic: These medications work to restore and maintain normal heart rhythm.

• Betapace (sotalol)

• Cordarone (amiodarone)

• Multaq (dronedarone)

• Rythmol (propafenone)

• Tikosyn (dofetilide)
  

• Tambocor (flecainide)

Anticoagulants: These medications prevent blood clot formation or treat an existing blood clot. The most commonly used anticoagulant for atrial fibrillation is Jantoven (warfarin).

Novel anticoagulant (NOAC) drugs: These newer versions of blood thinners offer an alternative to warfarin. They work by inhibiting the clotting factors in your blood. They include the following:

• Eliquis (apixaban)

• Pradaxa (dabigatran)

• Savaysa (edoxaban)

• Xarelto (rivaroxaban)
  

Antiplatelets: These medications target the activation of platelets to prevent blood clots. The most commonly used antiplatelet for atrial fibrillation is Durlaza (aspirin).

Procedures and Surgery

Treatment for atrial fibrillation also includes surgical and nonsurgical procedures. These therapies include the following:

• Cardioversion: This treatment involves the administration of an electrical shock to your chest using a set of paddles. It is quick, safe, painless, and very effective in life-threatening situations.

• Cardiac catheter ablation: Ablation involves mapping out the origins of extra electrical activity, then delivering energy in the form of radiofrequency, laser, or cryotherapy through a catheter to scar those areas. The scarred areas can't send abnormal signals.

• Maze procedure: The maze procedure is a type of cardiac ablation performed during open-heart surgery. It involves using radiofrequency or cryotherapy to make a series of scars on the atria. When scar tissue forms, it stops the irregular signals from the atria and allows your heartbeat to beat normally.
  

Learn More: How Atrial Fibrillation (A-Fib) Is Treated

Does Treatment Fix Atrial Fibrillation?

Atrial fibrillation is a lifelong condition that can't be cured. However, symptoms can be managed with proper medical treatment and oversight.

The right treatment can help prevent blood clots, slow a rapid heartbeat, or restore your heart's normal rhythm so you can live an active life. While successful treatment may restore a normal heart rhythm, atrial fibrillation eventually recurs in most people.

Living a Healthy Life With AFib

Living a healthy life with AFib is important for reducing your risk of atrial fibrillation events. Your healthcare provider can discuss the best strategy for your condition. Recommendations for living a healthy life with AFib often include the following:

• Establish and maintain a healthy weight to avoid being overweight or obese.

• Stay active by exercising 150 minutes per week of moderate-intensity aerobic exercise or 75 minutes per week of vigorous-intensity aerobic exercise, as the American Heart Association advises.

• Limit or avoid alcohol or stimulants that may affect your heart rate.

• Get professional help if you use recreational drugs.

• Manage stress and practice active relaxation techniques.

• Quit smoking.

• Follow a heart-healthy diet with less processed foods, more fresh fruits and vegetables, and limited salt.

• Manage blood pressure and cholesterol levels.

• Control blood glucose if you have diabetes.
  

Outlook for AFib

Everyone has a unique experience with atrial fibrillation. Your AFib outlook, or prognosis, is affected by factors that include the following:

• The severity or type of AFib

• Whether it is intermittent or constant
  

• Other health problems you might have

• Your age

• How your AFib is being treated

Atrial fibrillation can have a serious impact on your health. While the cause of death varies widely, mortality rates are generally four times higher in people with atrial fibrillation than in the general population.

However, the actual cause of death varies greatly. For most people, complications from atrial fibrillation, such as stroke, heart disease, and heart failure, rather than the disease itself, contribute to higher mortality rates.

Early diagnosis and treatment with medication, devices, and/or surgery can help control your heart rate and rhythm and prevent blood clots. Lifestyle changes can also reduce your risk of complications and improve your prognosis.

Learn More: How Treatment Improves Atrial Fibrillation Life Expectancy

Read the original article on Verywell Health.