Atrial fibrillation (AFib)

• AFib is a heart rhythm condition that can occur with or without symptoms.
• AFib causes can include high blood pressure, coronary heart disease, and other non-cardiac causes such as stress, obesity, and poor management of underlying health conditions.
• There are several medical procedures available for atrial fibrillation.

AFib is a heart rhythm condition that occurs frequently and is characterized by a racing, irregular heartbeat. In some cases, it can also occur without any symptoms. As it can lead to complications such as stroke, it’s essential to know the signs of atrial fibrillation, how it can be detected and diagnosed, and the possible and available treatment options. 

Atrial fibrillation, also known as AFib and often abbreviated as AF, is a heart rhythm condition that is marked by an irregular and often racing heartbeat. An irregular heart rhythm can cause serious health issues. 

Usually, the heart pumps blood throughout the body with a certain rhythm. With AFib, the irregular heart rhythm forms a problem for the heart’s normal function, as it won’t be able to pump out all the blood towards the rest of the body. The blood that remains in the heart can form clots, which can be pumped out of the heart and can block crucial blood vessels in other parts of the body, such as the brain. People who have atrial fibrillation and who aren’t receiving the appropriate treatment even run a risk of stroke due to these blood clots that are 5 times higher than the risk that other people may have. Atrial fibrillation life expectancy depends on whether or not the condition is being treated. 1

There are several types of atrial fibrillation, including: 1

1. Paroxysmal atrial fibrillation, which is a form of atrial fibrillation that comes and goes and only lasts for a few minutes to hours and up to 7 days in some people. The heart rhythm often restores on its own without any treatment.
2. Persistent atrial fibrillation, which is a form of atrial fibrillation that lasts for more than 7 days and requires treatment. 
3. Longstanding atrial fibrillation, which is a form of atrial fibrillation that lasts more than 12 months.
4. Permanent atrial fibrillation, which is defined as an irregular heart rhythm that lasts indefinitely. For this type of atrial fibrillation, treatment for AFib won’t work anymore.  

AFib is quite a common condition, with 1 in every 3 individuals older than 55 years being at risk of experiencing AFib at some point throughout their life. Atrial fibrillation also occurs more and more frequently. Studies estimate that in the United States alone, 6 to 12 million people will experience this condition by 2050. 2 3

AFib symptoms can vary from person to person, with some not experiencing any symptoms. For others, some of the common signs of AFib include: 4

• Heart palpitations 
• A rapid and irregular heartbeat
• Tiredness and difficulty exercising
• Breathlessness
• Feeling faint
• Dizziness
• Weakness
• Chest pain 

Atrial fibrillation symptoms can vary in severity and frequency. 

Many factors can contribute to AFib. What causes AFib is an issue with the heart's electrical signaling. When the signaling doesn't work as it should, the heart’s upper chambers start contracting irregularly, making it impossible for the upper and lower chambers of the heart to work together and pump blood around the body effectively. 5

The electrical signaling of the heart can be disturbed by a number of conditions, such as: 5

• High blood pressure
• Coronary heart disease 

Many factors can increase the risk of AFib. Some factors are modifiable, while you cannot do anything about some other factors. Some of these include: 5

• Age: if you’re over 65, then your risk of atrial fibrillation increases
• Family history: if heart conditions or atrial fibrillation run in your family, then your risk increases as well
• People with European ancestry are more likely to develop atrial fibrillation 

Apart from these risk factors, there are several modifiable factors and non-cardiac causes of atrial fibrillation that should be taken into account as well: 5

• Smoking
• Drinking alcohol
• Consuming illegal drugs
• Stress
• Strenuous activity
• Poor management of underlying health conditions such as COPD, chronic kidney disease, heart failure, high blood pressure, hyperthyroidism, sleep apnea, and diabetes
• Obesity

Your healthcare provider will ask questions to obtain your medical history and perform examinations to check your heart rate and rhythm. Atrial fibrillation can be detected on a variety of digital devices, wearables, and smartphone applications that use photoplethysmography (PPG) or electrocardiogram (ECG). AFib will show signs of irregular rhythm on PPG and ECG. 6

AFib treatment can include lifestyle changes, tackling underlying health issues, taking medicine, or undergoing a procedure to restore the heart rhythm to normal. Your healthcare provider will consider your medical history and symptoms to guide you to the correct atrial fibrillation treatments.  

Atrial fibrillation guidelines indicate that lifestyle changes and treating underlying health conditions are essential to reduce the risk of atrial fibrillation. Some lifestyle changes may include: 7

• Aiming for a healthy weight, as obesity is a significant risk factor for AFib
• Limiting the use of alcohol, nicotine, or any stimulants that may increase your heart rate
• Getting enough physical activity. However, keep in mind that long-term strenuous activity is not recommended. 
• Managing stress, as this can also trigger AFib episodes. 

Atrial fibrillation medication is often aimed at avoiding stroke by preventing blood clots from forming. AFib medication can also slow down your heart rate or restore your heart’s normal rhythm. The drug of choice for atrial fibrillation depends on your medical history and underlying factors. Some examples of medicines that your healthcare provider may prescribe you are: 7

• Beta-blockers
• Blood thinners
• Calcium channel blockers
• Heart rhythm medicines

Other atrial fibrillation treatments can be recommended if lifestyle changes and medicine do not help improve your symptoms. Some of these procedures can include: 7

• Atrial fibrillation cardioversion, which restores the heart rhythm using low-energy shocks.
• Atrial fibrillation catheter ablation, which restores the heart rhythm by destroying the tissue causing the arrhythmia.
• A pacemaker for AFib, which is usually only done if atrial fibrillation is diagnosed along with another arrhythmia. 
• Atrial fibrillation surgery can include surgery of the left upper chamber of the heart to help restore the heart’s normal rhythm. 

Atrial fibrillation is a heart rhythm condition that can lead to severe complications such as stroke. If the condition is detected early on and treatment initiated, complications can be prevented in many cases. Making lifestyle alterations, taking medication, and undergoing a procedure to restore the normal heart rhythm are possible AFib treatment options that may offer a solution if you’re experiencing symptoms of AFib. 

Q: What is paroxysmal atrial fibrillation? 
A: Paroxysmal atrial fibrillation is a form of atrial fibrillation that comes and goes and only lasts for a few days. The heart rhythm often restores on its own without any treatment.

Q: What causes atrial fibrillation? 
A: Atrial fibrillation is caused by an issue with the electrical signaling of the heart. This causes the upper heart chambers to contract irregularly. 

Q: What does atrial fibrillation feel like? 
A: Atrial fibrillation can feel like a pounding, racing heartbeat, which you can feel in your chest. It’s sometimes also described as a fluttering feeling in the chest. Some people may also experience chest pain, dizziness, and fatigue. 

Q: Does atrial fibrillation go away? 
A: In some cases, atrial fibrillation can go away on its own, or it can go away after making lifestyle changes or by taking medicine. In other cases, however, a procedure may be necessary.