Atrial fibrillation


Atrial fibrillation is an irregular and often fast heartbeat. Treating this condition is important for several reasons. It can cause blood clots, which can travel from your heart to your brain and cause a stroke. If you have a fast heartbeat, you may feel lightheaded, dizzy, and weak. An irregular heartbeat can also increase your risk for heart failure.

Atrial fibrillation is often the result of another heart condition, such as high blood pressure or coronary artery disease. Making changes to improve your heart condition will help you stay healthy and active.


What are the symptoms of atrial fibrillation?

Some people feel symptoms when they have episodes of atrial fibrillation. But other people don't notice any symptoms.

If you have symptoms, you may feel:

  • A fluttering, racing, or pounding feeling in your chest called palpitations.
  • Weak or tired.
  • Dizzy or lightheaded.
  • Short of breath.
  • Chest pain.

You may notice signs of atrial fibrillation when you check your pulse. Your pulse may seem uneven or fast.


Atrial fibrillation

Right and left atria of heart with details showing fibrillation in an atrium, and EKG patterns of fibrillation and normal rhythm.

In atrial fibrillation, erratic electrical impulses in the upper chambers of the heart (atria) cause those chambers to fibrillate, or quiver. This results in an irregular and frequently rapid heart rate. The irregular pattern in the electrocardiogram (EKG, ECG) tracing shows these erratic impulses.

What causes atrial fibrillation?

Atrial fibrillation is caused by a problem with the heart's electrical system. When something goes wrong with this system, it's usually because of other health problems that are causing wear and tear on the heart or making it hard for the heart to do its job.

Conditions that damage or strain the heart are the most common causes of atrial fibrillation. These include:

  • High blood pressure.
  • Coronary artery disease.
  • Heart attack.
  • Heart failure.
  • Heart valve disease.

Other possible causes include:

  • Having heart surgery or other open-chest surgery.
  • Hyperthyroidism.
  • Lung disease, such as COPD or pneumonia.
  • Drinking a large amount of alcohol at one time (binge drinking).

In some cases, doctors can't find the cause of atrial fibrillation.


How is atrial fibrillation diagnosed?

To check for atrial fibrillation, you will have an electrocardiogram (EKG). An EKG checks for problems with the heart's electrical activity.

Your doctor will probably ask questions about your past health and do a physical exam.

Other tests include:

Ambulatory electrocardiogram.
A device records the electrical activity of your heart while you do your usual activities. You may have this test if your doctor suspects that you have atrial fibrillation that comes and goes.
Electrophysiology (EP) study.
This test may be done to look for a problem with your heartbeat. A doctor may fix the problem too.
This test may be used to check for other heart problems. These include valve problems and heart failure.
A blood test.
You may have a blood test to check for hyperthyroidism.

Some people use wearable devices or smartphone devices to check their heart rate and rhythm. The results need to be confirmed by a doctor.


How is atrial fibrillation treated?

Treatments can help you feel better and prevent future problems, especially stroke and heart failure.

Your treatment may depend on the cause of your atrial fibrillation, your symptoms, your risk for stroke, and your preferences. Types of treatment include:

  • Heart rate treatment. Medicine may be used to slow your heart rate. Your heartbeat may still be irregular. But these medicines keep your heart from beating too fast. They may also help relieve symptoms.
  • Heart rhythm treatment. Different treatments may be used to try to stop atrial fibrillation and keep it from returning. They can also relieve symptoms. These treatments include:
    • Medicine.
    • Electrical cardioversion to shock the heart back to a normal rhythm.
    • A procedure called catheter ablation.
    • Heart surgery.
  • Stroke prevention. You and your doctor can decide how to lower your risk. You may decide to take a blood-thinning medicine called an anticoagulant.


How can you decide about electrical cardioversion for atrial fibrillation?

What are the options for treating atrial fibrillation?

Atrial fibrillation (say "AY-tree-uhl fih-bruh-LAY-shun") is a kind of uneven heartbeat. It can make you feel dizzy, tired, or short of breath. It also can make you more likely to have a stroke.

To treat it, you may:

  • Have electrical cardioversion.
  • Try other treatments to restore a normal heart rhythm and relieve your symptoms. You might try catheter ablation. Or you may take medicines to control your heart rate or rhythm.

Use this information to help you and your doctor decide if cardioversion may be a good option for you.

How does cardioversion treat atrial fibrillation?

Electrical cardioversion is one treatment option to try to stop atrial fibrillation and keep it from coming back. It can also relieve symptoms of atrial fibrillation.

First, you'll get medicines through a vein. They will block pain and make you sleepy (I.V. sedation). Then your doctor will put patches on your chest or your chest and back. The patches send a brief electric shock to your heart. This resets your heart rhythm.

Your doctor may have you take rhythm‐control medicines before and after cardioversion. These are called antiarrhythmics. They can make it more likely that your heart rhythm will get back to normal and stay there. You will probably take a blood-thinner medicine (anticoagulant). This is to prevent blood clots before and after the procedure. This medicine lowers your risk of a stroke.

For most people, this treatment restores a normal heart rhythm right away. But atrial fibrillation often comes back. If it does, talk with your doctor about your next treatment options. You may be able to have cardioversion again. Or your doctor might have you try a different treatment, such as catheter ablation. Or you might take medicines to control your heart rate or rhythm.

What are key points about this decision?

  • Cardioversion can return your heart to a normal rhythm. This helps relieve symptoms of atrial fibrillation.
  • For most people, cardioversion restores a normal heart rhythm right away. But atrial fibrillation often comes back. Many things can affect how long the heart stays in a normal rhythm. Your doctor can help you understand how well this treatment might work for you.
  • Cardioversion is just one way to treat atrial fibrillation. If atrial fibrillation returns after this procedure, you may try cardioversion again. Or you can choose another treatment.
  • Cardioversion does have some risks. These range from minor burns from the patches to a stroke. Your doctor can help you weigh your risks against the possible benefits.
  • No matter what treatment you choose, you will need to take steps to prevent a stroke, manage other health problems, and have a heart-healthy lifestyle.

Your decision

What you decide will depend on how you feel about the benefits and risks of your options. Talk to your doctor about what matters most to you. Together, you can make the decision that's right for you.

When to Call

Atrial fibrillation: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.
    After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
  • You have symptoms of a stroke. These may include:
    • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.
  • You passed out (lost consciousness).

Call your doctor now or seek immediate medical care if:

  • You have new or increased shortness of breath.
  • You feel dizzy or lightheaded, or you feel like you may faint.
  • You have an episode of atrial fibrillation and your doctor wants you to call when you have one.
  • You have new or worse symptoms.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.


How can you care for yourself when you have atrial fibrillation?

Many people are able to live full and active lives with atrial fibrillation.

Have a heart-healthy lifestyle.
Eat heart-healthy foods, be active, stay at a weight that is healthy for you, and get enough sleep. Try to quit or cut back on smoking. This lifestyle may help reduce how often you have episodes of atrial fibrillation. If you are overweight, losing weight can help relieve symptoms.
Take medicine properly and safely.
Take your medicine exactly as prescribed. If you take a blood thinner, be sure you get instructions about how to take your medicine safely.
Manage other health problems.
Manage diabetes, high blood pressure, and high cholesterol. Tell your doctor if you have symptoms of sleep apnea. If you think you may have a problem with alcohol or drug use, talk to your doctor.
Manage symptoms.
Work with your doctor to treat your symptoms and make an action plan for episodes.

Living well with atrial fibrillation

Most people with atrial fibrillation don't have to change their daily activities. You can live well and safely with atrial fibrillation. Here are some tips on preventing problems with arrhythmia.

  • Try to manage stress.

    Treatments like yoga, biofeedback, and meditation may help. Stress may trigger an episode of atrial fibrillation or make your atrial fibrillation worse.

  • Let your doctor know if you experience symptoms of atrial fibrillation during sex.

    Sex is safe for most people who have atrial fibrillation as long as they can exercise and be active without having symptoms.

  • Be active but watch for symptoms.

    For some people, strenuous activity can trigger an episode of atrial fibrillation. Tell your doctor if exercise is a trigger for you. Work with your doctor to create an activity plan that is right for you. Talk to your doctor before you start a new exercise program or change your workouts.

  • Pull over and call your doctor if you start to feel symptoms or become lightheaded while driving or using heavy machinery.

    You can drive unless your doctor advises against it.

  • Prepare before you travel.

    Bring the name and phone number of your doctor when you go on trips. Also, make sure to bring extra medicine.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.