What Is AFib?
Your heart normally beats in a steady, organized rhythm — like a drum keeping perfect time. In atrial fibrillation, the upper chambers of the heart (called the atria) fire off chaotic, disorganized electrical signals. Instead of beating in sync, they quiver rapidly and irregularly.
The result is an irregular heartbeat that can be too fast, too slow, or just unpredictable. AFib is the most common serious heart rhythm disorder, affecting more than 6 million Americans.
Normal Heartbeat vs AFib
Normal Heart Rhythm
AFib (Irregular)
Important: AFib itself is rarely immediately life-threatening, but it significantly raises your risk of stroke — up to 5 times the normal risk. That's why getting diagnosed and treated matters.
AFib can come and go on its own (called paroxysmal AFib), or it can be persistent or permanent. Some people live with it for years before being diagnosed.
Symptoms
Some people with AFib have no symptoms at all and are only diagnosed when a doctor notices an irregular pulse. Others feel it very clearly. Common symptoms include:
- Heart palpitations — a fluttering, racing, or pounding sensation in the chest
- Shortness of breath, especially with activity
- Fatigue or weakness that seems unusual
- Dizziness or lightheadedness
- Chest discomfort or pressure
- Reduced ability to exercise
AFib symptoms can come and go. Just because you feel fine doesn't mean the arrhythmia isn't happening. Many strokes caused by AFib occur in people who didn't know they had it.
How Is It Diagnosed?
Your doctor will start with a physical exam and listen to your heart. But the definitive test for AFib is an electrocardiogram (EKG or ECG) — a painless test that records your heart's electrical activity. It takes about 10 minutes and clearly shows an irregular rhythm.
Since AFib can be intermittent, you may need additional monitoring:
- Holter monitor: A portable EKG worn for 24–48 hours to catch episodes that come and go
- Event monitor: Worn for weeks at a time; you press a button when you feel symptoms
- Implantable loop recorder: A small device placed under the skin for longer-term monitoring
- Echocardiogram: An ultrasound of the heart to check structure and function
- Blood tests: To check thyroid function, kidney function, and other factors that can trigger AFib
Treatment Options
Treatment for AFib has two main goals: controlling the heart rate or rhythm, and preventing stroke. Your doctor will tailor the plan to your specific situation.
Rate Control
Medications like beta-blockers or calcium channel blockers slow the heart rate so it doesn't race, even if the rhythm is still irregular. Many people do very well long-term with rate control alone.
Rhythm Control
The goal here is to restore and maintain a normal heartbeat. Options include:
- Antiarrhythmic medications to keep the heart in normal rhythm
- Cardioversion: A brief, controlled electrical shock that resets the heart rhythm (done under sedation — you won't feel it)
- Catheter ablation: A minimally invasive procedure where a cardiologist uses heat or cold energy to destroy the small areas of heart tissue triggering AFib
Stroke Prevention
This is often the most important part of AFib treatment. Blood thinners (anticoagulants) such as warfarin or newer medications like apixaban (Eliquis), rivaroxaban (Xarelto), or dabigatran (Pradaxa) significantly reduce stroke risk. Your doctor will calculate your personal stroke risk to decide if a blood thinner is right for you.
Lifestyle Changes
Managing AFib triggers can make a real difference: reducing alcohol, treating sleep apnea, losing weight if needed, staying active, and managing stress all help.
📺 Video Resources
Watch Dr. Pollock explain atrial fibrillation, how it's treated, and what you need to know about managing AFib.
When to Seek Care
- Sudden chest pain or pressure
- Sudden weakness or numbness on one side of the body
- Sudden trouble speaking or understanding speech
- Sudden vision changes
- Fainting or loss of consciousness
- Severe shortness of breath at rest
Call your doctor promptly (don't wait) if you notice a new irregular heartbeat, palpitations that are new or worsening, or if you're more short of breath than usual. AFib caught early is much easier to treat.