Vasculearn Network
Atrial Fibrillation (AFib)
Atrial fibrillation is a common heart rhythm condition where the upper chambers beat irregularly, so the heart pumps blood less efficiently.
Atrial fibrillation (AFib) is a heart rhythm condition in which the upper chambers of the heart beat irregularly and often too quickly. Instead of squeezing in a steady pattern, they quiver. This affects how blood moves through the heart.
AFib matters because it can increase the risk of stroke and heart failure. With proper treatment and follow-up, many people live full and active lives.
Types of Atrial Fibrillation
AFib does not look the same for everyone. Clinicians describe AFib based on how long episodes last and whether the rhythm returns to normal.
Common types include:
- Paroxysmal AFib: Episodes come and go on their own. They usually stop within 7 days.
- Persistent AFib: The irregular rhythm lasts longer than 7 days and may require treatment to restore normal rhythm.
- Long-standing persistent AFib: AFib continues for more than 12 months.
- Permanent AFib: The heart rhythm remains irregular, and you and your clinician decide not to attempt restoring a normal rhythm.
Symptoms
Some people notice clear symptoms. Others have no symptoms at all. AFib may be found during a routine exam.
Common symptoms include
- Fluttering, racing, or irregular heartbeat
- Feeling tired or low on energy
- Shortness of breath, especially with activity
- Dizziness or light-headedness
- Chest discomfort
- Feeling weak or less able to exercise
Causes & Risk Factors
AFib develops when the heart’s electrical signals do not move in a steady, organized pattern. Certain conditions directly affect heart tissue, while others increase strain on the heart.
Causes
AFib occurs when abnormal electrical signals in the upper chambers disrupt the normal heartbeat. Instead of contracting in a coordinated way, the atria quiver. This can allow blood to pool inside the heart, which increases the risk of clot formation.
Direct causes often involve structural or electrical changes in the heart, such as:
- Coronary artery disease
- Heart valve disease
- Heart failure
- Scarring after heart surgery
- Inflammation or infection affecting heart tissue
Risk Factors
Some factors increase the likelihood of developing AFib.
Modifiable risk factors
- High blood pressure
- Diabetes
- Sleep apnea
- Obesity
- Excess alcohol use
- Smoking
- Physical inactivity
Non-modifiable risk factors
- Older age
- Family history of AFib
- Certain genetic traits
AFib is more common in older adults and occurs more often in White adults, but it affects people of all backgrounds.
Diagnosis
Clinicians diagnose AFib using your medical history, a physical exam, and heart rhythm tests.
Common tests include:
- Electrocardiogram (ECG or EKG): Records the heart’s electrical activity and can confirm an irregular rhythm
- Heart monitor: A portable device worn for days or weeks to detect AFib that comes and goes
- Echocardiogram: An ultrasound that shows heart structure and pumping function
- Blood tests: Check thyroid function and other conditions that may trigger rhythm changes
AFib doesn’t always occur constantly. Some people need extended monitoring before clinicians confirm the diagnosis.
Treatments
The goals of treatment are to control heart rate, maintain a steady rhythm when appropriate, reduce the risk of stroke, and address underlying risk factors. Not every person needs every treatment. Care depends on symptoms, overall health, and stroke risk.
Lifestyle Changes
Healthy habits support heart rhythm and reduce complications.
- Managing blood pressure
- Maintaining a healthy weight
- Limiting alcohol
- Treating sleep apnea
- Staying physically active in safe ways
- Managing stress
Even small changes can support heart health.
Medications
Medications may help:
- Slow the heart rate
- Maintain a regular rhythm
- Reduce the risk of blood clots
Blood thinners reduce the risk of stroke by lowering the chance of clot formation. You may need a blood thinner even if you do not feel symptoms. Stroke risk depends on factors such as age, blood pressure, and other medical conditions, not just how AFib feels.
Procedures
Some people benefit from procedures if medications do not control symptoms.
- Cardioversion: A controlled electrical treatment that restores normal rhythm
- Catheter ablation: A procedure that targets small areas of heart tissue causing abnormal signals
- Pacemaker: A device that helps regulate heart rhythm in certain situations
Procedures are not needed for everyone. Decisions depend on symptom severity and response to treatment.
Living Well & Prevention
AFib is often a long-term condition. Ongoing care helps reduce complications and improve quality of life.
Regular follow-up visits allow clinicians to:
- Monitor heart rhythm
- Adjust medications
- Assess stroke risk
- Review side effects
Prevention focuses on managing underlying conditions and supporting heart health.
You can lower risk by:
- Controlling blood pressure
- Managing diabetes
- Maintaining a healthy weight
- Limiting alcohol
- Avoiding tobacco
- Staying physically active
Many people with AFib live full, active lives with proper treatment and monitoring.
vln.org/learn/topics/atrial-fibrillation