Atrial fibrillation (Afib) is an irregular heart rhythm that begins in your heart’s upper chambers (atria). Symptoms include fatigue, heart palpitations, trouble breathing and dizziness. Afib is one of the most common arrhythmias. Risk factors include high blood pressure, coronary artery disease and having obesity. Untreated Afib can lead to a stroke.
Afib (atrial fibrillation) is an irregular heart rhythm (arrhythmia) that begins in the upper chambers (atria) of your heart. With Afib, your heart’s electrical system doesn’t work as it should. Instead of a steady, regular pattern of electrical impulses firing, many different impulses fire rapidly at the same time.
This causes a fast, chaotic rhythm in your atria instead of a regular rhythm and pace. As a result, your atria can’t do a good job of contracting or pumping blood into your lower chambers (ventricles). Your ventricles, which respond to your atria, also contract irregularly, causing a rapid, irregular heartbeat. (The heartbeat and pulse that you feel come from your ventricles’ contractions.) Your ventricles may get 140 to 160 signals per minute instead of the normal 60 to 100 per minute.
You can think of Afib like several conductors directing an orchestra instead of just one. The musicians wouldn’t know who to follow or what to do. The music would lose its rhythm.
Atrial fibrillation can lead to a stroke and other serious medical issues like heart failure. That’s why it’s important to learn the symptoms and talk with your healthcare provider about your personal risk factors.
Fortunately, there are many ways to bring back your heart’s rhythm if you have Afib. It all starts with a visit to your healthcare provider, who can run some tests and make a diagnosis.
Providers classify atrial fibrillation based on how long the Afib episodes last.
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Some people have symptoms, and some don’t. It depends on how fast your ventricles are beating. If they’re beating at a normal or slightly elevated pace, you probably won’t feel anything. But if your ventricles beat faster, you’ll start to notice symptoms. These can include:
If you have atrial fibrillation symptoms, keep a list of when they happen and share this information with your healthcare provider right away.
Changes or damage to your heart’s tissue and electrical system cause atrial fibrillation. Usually, coronary artery disease, high blood pressure or heart failure can cause these changes. Other causes include heart valve issues, hyperthyroidism or excessive alcohol use. Sometimes, when your body is sick for other reasons (like blood loss or severe infection), the stress response from the illness can cause Afib.
Often, a prematurely triggered heartbeat (which feels like a skipped beat) causes atrial fibrillation to begin. These are more common in the conditions above. But sometimes, it’s hard to know the cause of that triggered heartbeat. For some people, there’s no identifiable cause.
While atrial fibrillation can affect anyone, it’s more common among people of European descent. But Black people who have Afib are more likely to have serious complications like stroke or heart failure. People assigned female at birth (AFAB) get a diagnosis more often than people assigned male at birth (AMAB).
Afib often runs in families. If someone in your biological family has Afib, you have a higher chance of developing it, too.
The older you get, the greater your risk for atrial fibrillation. At 65 years old, your risk especially increases. Besides increasing age, high blood pressure is a huge risk factor. High blood pressure causes 1 in 5 cases of Afib. You also have a higher risk of developing Afib if you have any of the following conditions:
In addition, using tobacco products, recreational drugs or beverages containing alcohol can raise your risk.
While physical activity strengthens your heart, some athletes who exercise intensely for long periods of time could have a higher risk of Afib. In those rare cases, reducing the intensity of activity usually helps.
An estimated 1 in 3 people with Afib doesn’t know they have it. That’s why it’s important to know the risk factors and talk with your healthcare provider. If you’re at risk, you should have your heart and pulse checked regularly so you can catch problems early.
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Atrial fibrillation can cause serious medical complications. So, it’s essential to learn the warning signs and to share them with your family and friends. In many cases, you need someone else to call 911. Immediately call 911 (or your local emergency services) if you have the following symptoms or if you notice them in someone around you:
If you or a loved one has Afib, it’s a good idea to talk with your healthcare provider about how to get help in medical emergencies. For those who live alone or spend lots of time alone, medical alert devices may be a life-saving resource.
To diagnose atrial fibrillation, your healthcare provider will first ask you some questions. They’ll ask about what you eat, your physical activity, biological family history, any symptoms you’ve noticed and risk factors. Your provider will then give you a physical exam that includes:
This exam will help your provider understand your baseline health and how your body is functioning.
In addition to the physical exam, your provider may run some tests to make an atrial fibrillation diagnosis. These tests include:
In some cases, your provider may want to check how your heart rhythm looks in your daily life. If so, they’ll ask you to wear a Holter monitor (for one or two days) or a portable event monitor (for up to one month) to record your heart’s activity.
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The main goals of Afib treatment include:
Based on your symptoms, your healthcare provider will likely prescribe medications first to see if they help.
Some medications for atrial fibrillation treatment may keep your ventricles from beating too fast. They include:
Afib treatments that help your heart beat in a normal sinus rhythm include:
Atrial fibrillation treatments that reduce your risk of blood clots and stroke include:
If medications don’t help your Afib, you may need a procedure or surgery. Many procedures can be noninvasive, and newer treatment methods and technologies are constantly developing. Talk with your provider about the best options for you.
Treatments may include:
While you can’t get rid of all of your risk factors for Afib, you may be able to change four major ones: obesity, physical inactivity, excessive alcohol consumption and tobacco use. Here are some tips to lower your risk:
As you lower these risk factors, you’ll also see other benefits like reduced blood pressure, lower cholesterol levels and weight loss. When it comes to heart health, each positive lifestyle change has a ripple effect. The more changes you can make, the more benefits you’ll enjoy in the long run.
Afib may keep coming back, even with treatment. As atrial fibrillation progresses, it becomes more serious and harder to treat. Medicines that helped you in the past may not help in the future. Healthcare providers can’t cure Afib, but they can manage your symptoms. Talk with your healthcare provider about the best management and treatment plan for you.
The same habits that lower your risk of Afib help you feel better when you have it. Eating healthy foods and getting 30 minutes of physical activity five days a week helps your heart. You can break up your activity into 10-minute chunks to make it easier. Cutting out tobacco products and alcohol is good for your heart, too.
There’s no single schedule to follow. It all depends on your symptoms and treatment plan, and whether you need follow-ups after a procedure. So, it’s important to talk with your provider and make a plan together. Make sure you go to all your scheduled appointments. Keep track of the medications you’re taking and bring a list of your medications to every visit. It’s also a good idea to keep the list in your wallet so it’s with you in emergencies.
At each visit, be sure to share any new symptoms or problems you’re having, like side effects from medication. Be sure to ask your provider before taking over-the-counter (OTC) medicines, like those for cold and flu, and nutritional supplements. Sometimes, these products can affect your heart rate or interact with your prescription medications.
Questions to consider asking your provider may include:
If you think you have Afib symptoms, it’s important to call your healthcare provider right away to discuss how you’re feeling. Your provider may ask you to check your pulse. If it feels erratic or weak, that could be a sign you’re in Afib.
But sometimes, you might not notice any changes in your pulse, especially if your Afib isn’t advanced. You may instead just feel tired or out of breath. You may not know if your symptoms are from Afib or something else. That’s why a call to your provider is essential. You can’t diagnose Afib yourself.
More than 33 million people age 55+ worldwide have an Afib diagnosis. Estimates predict that 12 million people in the U.S. will have Afib by 2030. Afib causes nearly half a million hospitalizations a year in the U.S. and leads to more and more deaths with each passing year.
A note from Cleveland Clinic
Atrial fibrillation is a complex heart condition that can seem scary, confusing or overwhelming. But whether you suspect you might have Afib, were recently diagnosed or have been living with it for years, you’re not alone. You’re one of the millions of people learning new strategies for managing Afib while still enjoying life. That’s why it’s important to talk with your healthcare provider and learn more about available resources and support communities.
It’s also helpful to learn about the benefits and risks of treatment options. All medications or procedures carry some risks. But when it comes to Afib, treatment is essential for supporting your heart and reducing your chances of having a stroke. Your provider will work with you to choose the best approach.
Last reviewed on 07/25/2024.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy