Overview
Atrial fibrillation
Atrial fibrillation
In a typical heart, a tiny cluster of cells at the sinus node sends out an electrical signal. The signal then travels through the atria to the atrioventricular (AV) node and passes into the ventricles, causing them to contract and pump out blood. In atrial fibrillation, electrical signals fire from multiple locations in the atria (typically pulmonary veins), causing them to beat chaotically. Since the atrioventricular (AV) node doesn't prevent all of these chaotic signals from entering the ventricles, the heart beats faster and irregularly.
Atrial fibrillation (A-fib) is an irregular and often very rapid heart rhythm (arrhythmia) that can lead to blood clots in the heart. A-fib increases the risk of stroke, heart failure and other heart-related complications.
During atrial fibrillation, the heart's upper chambers (the atria) beat chaotically and irregularly — out of sync with the lower chambers (the ventricles) of the heart. For many people, A-fib may have no symptoms. However, A-fib may cause a fast, pounding heartbeat (palpitations), shortness of breath or weakness.
Episodes of atrial fibrillation may come and go, or they may be persistent. Although A-fib itself usually isn't life-threatening, it's a serious medical condition that requires proper treatment to prevent stroke.
Treatment for atrial fibrillation may include medications, therapy to reset the heart rhythm and catheter procedures to block faulty heart signals.
A person with atrial fibrillation may also have a related heart rhythm problem called atrial flutter. Although atrial flutter is a different arrhythmia, the treatment is quite similar to atrial fibrillation.
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Symptoms
Some people with atrial fibrillation (A-fib) don't notice any symptoms. Those who do have atrial fibrillation symptoms may have signs and symptoms such as:
- Sensations of a fast, fluttering or pounding heartbeat (palpitations)
- Chest pain
- Dizziness
- Fatigue
- Lightheadedness
- Reduced ability to exercise
- Shortness of breath
- Weakness
Atrial fibrillation may be:
- Occasional (paroxysmal atrial fibrillation). A-fib symptoms come and go, usually lasting for a few minutes to hours. Sometimes symptoms occur for as long as a week and episodes can happen repeatedly. Symptoms might go away on their own. Some people with occasional A-fib need treatment.
- Persistent. With this type of atrial fibrillation, the heart rhythm doesn't go back to normal on its own. If a person has A-fib symptoms, cardioversion or treatment with medications may be used to restore and maintain a normal heart rhythm.
- Long-standing persistent. This type of atrial fibrillation is continuous and lasts longer than 12 months.
- Permanent. In this type of atrial fibrillation, the irregular heart rhythm can't be restored. Medications are needed to control the heart rate and to prevent blood clots.
When to see a doctor
If you have any signs or symptoms of atrial fibrillation, make an appointment with your doctor.
If you have chest pain, seek immediate medical help. Chest pain could mean that you're having a heart attack.
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Causes
To understand the causes of A-fib, it may be helpful to know how the heart typically beats.
The typical heart has four chambers — two upper chambers (atria) and two lower chambers (ventricles). Within the upper right chamber of the heart (right atrium) is a group of cells called the sinus node. The sinus node is the heart's natural pacemaker. It produces the signal that starts each heartbeat.
In a regular heart rhythm:
- The signal travels from the sinus node through the two upper heart chambers (atria).
- The signal passes through a pathway between the upper and lower chambers called the atrioventricular (AV) node.
- The movement of the signal causes your heart to squeeze (contract), sending blood to your heart and body.
In atrial fibrillation, the signals in the upper chambers of the heart are chaotic. As a result, the upper chambers shake (quiver). The AV node is then bombarded with signals trying to get through to the lower heart chambers (ventricles). This causes a fast and irregular heart rhythm.
The heart rate in atrial fibrillation may range from 100 to 175 beats a minute. The normal range for a heart rate is 60 to 100 beats a minute.
Causes of atrial fibrillation
Problems with the heart's structure are the most common cause of atrial fibrillation. Possible causes of atrial fibrillation include:
- Coronary artery disease
- Heart attack
- Heart defect that you're born with (congenital heart defect)
- Heart valve problems
- High blood pressure
- Lung diseases
- Physical stress due to surgery, pneumonia or other illnesses
- Previous heart surgery
- Problem with the heart's natural pacemaker (sick sinus syndrome)
- Sleep apnea
- Thyroid disease such as an overactive thyroid (hyperthyroidism) and other metabolic imbalances
- Use of stimulants, including certain medications, caffeine, tobacco and alcohol
- Viral infections
Some people who have atrial fibrillation have no known heart problems or heart damage.
Risk factors
Things that can increase the risk of atrial fibrillation (A-fib) include:
- Age. The older a person is, the greater the risk of developing atrial fibrillation.
- Heart disease. Anyone with heart disease — such as heart valve problems, congenital heart disease, congestive heart failure, coronary artery disease, or a history of heart attack or heart surgery — has an increased risk of atrial fibrillation.
- High blood pressure. Having high blood pressure, especially if it's not well controlled with lifestyle changes or medications, can increase the risk of atrial fibrillation.
- Thyroid disease. In some people, thyroid problems may trigger heart rhythm problems (arrhythmias), including atrial fibrillation.
- Other chronic health conditions. People with certain chronic conditions such as diabetes, metabolic syndrome, chronic kidney disease, lung disease or sleep apnea have an increased risk of atrial fibrillation.
- Drinking alcohol. For some people, drinking alcohol can trigger an episode of atrial fibrillation. Binge drinking further increases the risk.
- Obesity. People who have obesity are at higher risk of developing atrial fibrillation.
- Family history. An increased risk of atrial fibrillation occurs in some families.
Complications
Blood clots are a dangerous complication of atrial fibrillation that can lead to stroke.
In atrial fibrillation, the chaotic heart rhythm can cause blood to collect in the heart's upper chambers (atria) and form clots. If a blood clot in the left upper chamber (left atrium) breaks free from the heart area, it can travel to the brain and cause a stroke.
The risk of stroke from atrial fibrillation increases as you grow older. Other health conditions also may increase your risk of a stroke due to A-fib, including:
- High blood pressure
- Diabetes
- Heart failure
- Some valvular heart disease
Blood thinners are commonly prescribed to prevent blood clots and strokes in people with atrial fibrillation.
Prevention
Healthy lifestyle choices can reduce the risk of heart disease and may prevent atrial fibrillation. Here are some basic heart-healthy tips:
- Eat a nutritious diet
- Get regular exercise and maintain a healthy weight
- Don't smoke
- Avoid or limit alcohol and caffeine
- Manage stress, as intense stress and anger can cause heart rhythm problems
By Mayo Clinic Staff
Oct. 19, 2021
FAQs
What are early warning signs of AFib? ›
- Palpitations – the heart may feel like it's racing, fluttering, pounding, thumping or beating irregularly.
- Chest pain, pressure or discomfort.
- Dizziness, light-headedness or faintness.
- Shortness of breath.
- Fatigue or lack of energy (in general or while exercising)
- Weakness.
- Sweating.
- Anxiety.
AFib may be brief, with symptoms that come and go. It is possible to have an atrial fibrillation episode that resolves on its own. Or, the condition may be persistent and require treatment. Sometimes AFib is permanent, and medicines or other treatments can't restore a normal heart rhythm.
What is the most common trigger for AFib? ›"But poor sleep is just one of many triggers for Afib," said Ghannam, noting alcohol, excessive exercise, dehydration, stress and consuming large meals as some of the more common ones.
What should you not do if you have atrial fibrillation? ›If you have A-fib , it's also important to know which foods and drinks to avoid. For example, your care provider may recommend that you limit or avoid alcohol. Alcohol can cause health issues in some people. People with atrial fibrillation often take blood thinners to prevent blood clots.
Does AF damage the heart? ›Treatment and improving lifestyle is important because untreated AF can increase the risk of stroke, heart failure and other heart-related problems.
What is the first drug of choice for atrial fibrillation? ›Beta blockers and calcium channel blockers are the drugs of choice because they provide rapid rate control. These drugs are effective in reducing the heart rate at rest and during exercise in patients with atrial fibrillation.
What is the heart rate for atrial fibrillation? ›The most obvious symptom of atrial fibrillation (AF) is palpitations caused by a fast and irregular heartbeat. A normal heart rate, when you are resting, should be between 60 and 100 beats a minute. In atrial fibrillation, it may be over 140 beats a minute.
Why does atrial fibrillation suddenly start? ›The cause is not fully understood, but it tends to affect certain groups of people, such as older people and people living with long-term (chronic) conditions such as heart disease, high blood pressure or obesity. It may be triggered by certain situations, such as drinking too much alcohol or smoking.
What foods cause atrial fibrillation? ›Some research has shown that diets high in saturated and trans fats may be associated with an increased risk of AFib and other cardiovascular conditions ( 20 , 21 ). Foods like butter, cheese, and red meat have high amounts of saturated fat. Trans fats are found in: margarine.
What are the symptoms of AFib getting worse? ›If you notice that your AFib episodes happen more often, last longer, or your medication doesn't help as much, your condition is probably getting worse. As AFib progresses, you might notice some signs. You might feel more weak, tired, lifeless, and anxious about the condition.
What is the best sleeping position for atrial fibrillation? ›
There is no clear sleep position that is beneficial for atrial fibrillation. However, most AFib patients notice less symptoms while sleeping on their side. Some patients prefer the left side, while others prefer the right side.
How can I correct my atrial fibrillation naturally? ›- Avoid stimulants.
- Get your nutrients.
- Stay hydrated.
- Supplements.
- Cut out gluten.
- Exercise and stress relief.
- Q&A.
In fact, walking can prove quite beneficial to the health and longevity of a person living with AFib. Why? Aside from its long-term health benefits, such as lower blood pressure and resting heart rate and improved mental well-being, walking can help reduce the onset of AFib symptoms.
What is the number one complication of atrial fibrillation? ›Heart failure
If your atrial fibrillation is persistent, it may start to weaken your heart. In extreme cases, it can lead to heart failure, as your heart is unable to pump blood around your body efficiently.
...
Exercise regularly
- brisk walking.
- jogging.
- running.
- biking.
- swimming.
When to Call the Doctor or 911. If an AFib episode lasts 24 to 48 hours with no break or if symptoms worsen, call your physician, Armbruster says. Call 911 or go to the emergency room immediately if you experience any symptoms of a stroke, which are sudden weakness or numbness or difficulty speaking or seeing.
What is the safest AFib medication? ›Of all antiarrhythmic agents, dofetilide and amiodarone have been proven safe in patients with heart failure.
How do you get rid of AFib without medication? ›- manage your blood pressure.
- manage your cholesterol levels.
- eat a heart-healthy diet.
- exercise for 20 minutes most days of the week.
- quit smoking if you smoke.
- maintain a healthy weight.
- get enough sleep.
- drink alcohol in moderation.
A beta blocker, such as bisoprolol or atenolol, or a calcium channel blocker, such as verapamil or diltiazem, will be prescribed. The medicine you'll be offered will depend on what symptoms you're having and your general health. A medicine called digoxin may be offered if other drugs are not suitable.
What happens if you are in AFib all the time? ›Outlook for persistent AFib
Untreated persistent AFib can lead to permanent AFib. Having any form of AFib, including persistent AFib, increases your risk for stroke, heart attack, and death. The best way to prevent complications from AFib is to carefully manage and treat it.
How long does it take for atrial fibrillation to go away? ›
Paroxysmal Afib lasts less than one week and usually stops on its own without treatment. (Paroxysmal is pronounced par-ək-ˈsiz-məl.) 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.
At what heart rate does AFib start? ›Symptoms of atrial fibrillation
A normal heart rate, when you are resting, should be between 60 and 100 beats a minute. In atrial fibrillation, it may be over 140 beats a minute. If you notice an irregular heartbeat and/or have chest pain, see your doctor immediately.
A-fib can affect any adult at any age. While most patients develop it in their 60s, 70s, or 80s, I also see some young adults in their 20s or 30s with this condition.
How can I check for AFib at home? ›If you suspect you have Afib, checking your pulse can be a simple way to listen in on your heart beat and check for irregularities. To do this, put the index and middle fingers of your right hand on the inside of your left wrist, and feel for a pulse.
How can I check if I have AFib? ›An ECG can show if the heart is beating too fast, too slow or not at all. An ECG is the main test for diagnosing atrial fibrillation. Blood tests. These help a doctor rule out thyroid problems or detect other substances in the blood that may lead to A-fib .
How do I get my heart back in rhythm? ›Cardioversion is a medical procedure that uses quick, low-energy shocks to restore a regular heart rhythm. It's a treatment for certain types of irregular heartbeats (arrhythmias), including atrial fibrillation (A-fib). Sometimes cardioversion is done using medications.
Is AFib always seen on EKG? ›It gives your doctor a picture of your heart's overall electrical activity. But because the test is a quick snapshot, a standard EKG won't always catch AFib. Sometimes you'll need a portable heart rhythm monitor to keep tabs on your ticker over a longer time.
Is AFib the beginning of heart failure? ›AFib can lead to heart failure, and heart failure puts you at greater risk for AFib. When you have both, which is common, symptoms tend to be worse than when you have just one or the other.
Can you have AFib for years and not know it? ›You may think you're out of shape or just don't feel like yourself. But you could have AFib and not even know it. Some people have no symptoms at all. You might hear it called silent AFib.
Does AFib cause low oxygen levels? ›AFib leads to a loss of “atrial kick”, which results in a 30% loss of output from the heart. In turn, your organs tell the brain to send more oxygen, and the brain instructs the lungs to work harder. This manifests as heavier, faster breathing – it's an involuntary response to oxygen-starved tissues.
Should I see a cardiologist if I have atrial fibrillation? ›
You should see your doctor if you're having symptoms of AF. Your doctor will find a treatment to control the rate and rhythm of your heart. This may include: medication such as beta blockers and anti-arrhythmic drugs.
What medications can cause atrial fibrillation? ›New-onset AF has been associated with cardiovascular drugs such as adenosine, dobutamine, and milrinone. In addition, medications such as corticosteroids, ondansetron, and antineoplastic agents such as paclitaxel, mitoxantrone, and anthracyclines have been reported to induce AF.
Can you have AFib with a normal pulse? ›In some cases it's possible to have A-Fib and still have what appears to be a regular heart rate. Your atria can be fibrillating, even though your heart doesn't beat rapidly.
What should your blood pressure be if you have AFib? ›The longer you go with high blood pressure, the more likely you are to develop AFib. Failing to keep your blood pressure in a healthy range (120/80 mm Hg is ideal), especially after middle age, may be the single most counterproductive measure to controlling or preventing a heart rhythm disorder.