Updated
What is AFib?
AFib is a rhythm in which the upper heart chambers activate in a disorganized way. The pulse is often irregular and may be fast. Some people notice fluttering, tiredness or breathlessness; others have no symptoms.
An ECG recording is used to confirm the rhythm. If episodes come and go, a wearable monitor can help capture them. A watch notification is a reason to discuss testing, not a complete diagnosis by itself.
Three parts of treatment
- Stroke prevention: your clinician estimates your stroke risk and considers whether an anticoagulant is appropriate. Aspirin is not an equivalent substitute. Bleeding history, kidney function, other medicines and valve conditions matter.
- Rate control: medicines can slow a fast heart rate.
- Rhythm control: cardioversion, medicines or catheter ablation may help restore or maintain a usual rhythm. Earlier rhythm treatment may be useful for selected people.
Feeling better after cardioversion or ablation does not automatically mean it is safe to stop an anticoagulant. Make that decision with your clinician based on stroke risk.
What you can do
Discuss a realistic activity plan, blood pressure control, sleep apnea evaluation when appropriate, and reducing or avoiding alcohol. If weight loss is recommended, ask for a sustainable plan. Keep a list of medicines and bring a record of symptoms and pulse readings to appointments.
Tell your care team about missed doses, side effects and cost barriers. Before procedures or dental work, ask the prescribing clinician for an anticoagulation plan.
When to seek care
Call 911 for signs of stroke, such as a drooping face, arm weakness or trouble speaking, or for severe chest pain, fainting or severe breathing difficulty. If you take an anticoagulant, major bleeding or a significant head injury needs urgent assessment.
For sustained palpitations, a change in your usual symptoms or medication concerns, follow the contact plan from your care team. A monitor is not a substitute for emergency care.
Questions for your next visit
- What is my stroke risk, and do I need an anticoagulant?
- Should we discuss rate control, rhythm control or both?
- What should I do during an episode?
References and further reading
Use these sources with your own clinician's advice. Recommendations depend on your health history and can change as evidence develops.