Atrial Fibrillation
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Atrial fibrillation (say: AY-tree-al fib-ril-LAY-shun), often called AF or AFib, is a heart rhythm problem. In a normal heart, the upper chambers (atria) squeeze in a steady, organised way. With AF, the electrical signals become chaotic, so the atria quiver instead of squeezing properly. This can make the heartbeat feel irregular and sometimes fast. It’s not usually life-threatening on its own, but it can increase the risk of a stroke because blood may pool and form clots.
Key facts
- AF is one of the most common heart rhythm disorders.
- It can come and go (paroxysmal) or be present all the time (persistent or permanent).
- Treatment focuses on controlling the heart rate, restoring a normal rhythm, and preventing blood clots.
- Many people with AF live full, active lives with the right care.
Yes, it is very common, especially in people over 65. Around 1 in 25 people aged 60 or older have AF, and this increases with age.
It can affect anyone, but it’s most often seen in older adults and people with conditions like high blood pressure, heart disease, or diabetes. It can also run in families.
Symptoms
- Sudden severe chest pain that spreads to your arms, back, neck, or jaw
- Collapse or fainting with loss of consciousness
- Signs of a stroke: face drooping on one side, arm weakness, speech difficulty, sudden confusion, vision changes, trouble walking, or a severe headache with no known cause
- Severe shortness of breath that doesn’t improve with rest
- ⚠Palpitations that last for several hours or keep coming back
- ⚠Increasing breathlessness when doing your usual activities
- ⚠Feeling very unwell, dizzy, or unable to eat or drink normally
- ⚠Unexpected swelling in the feet or ankles
Common symptoms
- Palpitations (a feeling that your heart is pounding, fluttering, or skipping beats)
- Feeling very tired, even after little activity
- Shortness of breath, especially during exercise or when lying down
- Dizziness or light-headedness
- Chest discomfort or tightness
- Feeling faint or actually fainting (less common)
Symptoms in children
- AF is extremely rare in children. If it occurs, a child might complain of a racing heart, feel tired quickly during play, or seem breathless. Always see a paediatrician if you notice an unusual heart rhythm in a child.
Symptoms in older adults
- Older adults may have similar symptoms, but sometimes AF is found during a routine check-up with no obvious signs. It can also make other conditions worse, such as heart failure or fatigue, or even cause confusion.
Causes
Main causes
- The exact trigger for the chaotic electrical signals is often not clear, but AF is usually linked to underlying changes in the heart. Common associated conditions include:
- High blood pressure (hypertension) – puts strain on the heart
- Heart valve disease – valves not opening or closing properly
- Coronary artery disease – narrowed heart arteries
- Heart failure – the pump function is weakened
- Overactive thyroid gland (hyperthyroidism)
- Lung conditions like chronic obstructive pulmonary disease (COPD) or a serious chest infection
- Sleep apnoea – pauses in breathing during sleep
- Excessive alcohol intake, especially binge drinking
- High stress or prolonged anxiety
When to see a doctor
See a doctor urgently if:
- If you have palpitations that don’t settle after a few minutes, or they come with chest pain, fainting, or difficulty breathing, seek urgent medical help. Contact your healthcare provider or call your local non-emergency medical helpline for advice (such as NHS 111 in the UK).
Book a routine appointment if:
- Make a routine appointment if you sometimes notice your heart beating irregularly or very fast but you otherwise feel well. If you are in a high-risk group (over 65, or have high blood pressure), ask about a heart check-up even without symptoms.
Diagnosis
A doctor will listen to your heart, check your pulse, and ask about your health history. The key test is an electrocardiogram (ECG) – a quick, painless recording of the heart’s electrical activity. Sometimes AF is picked up during a routine exam.
Tests that may be done
- Electrocardiogram (ECG) – stickers are placed on your chest to record the heart’s rhythm for a few seconds
- Holter monitor or event recorder – a small portable device you wear for 24 hours, a week, or longer to catch rhythm changes over time
- Echocardiogram (echo) – an ultrasound scan that shows the heart’s structure and how well it pumps
- Blood tests – to check for thyroid problems, kidney function, and other imbalances
- Stress test or sleep study – only if the doctor suspects an underlying trigger like blocked arteries or sleep apnoea
What to expect at your appointment
The tests are painless and usually done as an outpatient. The ECG takes only a few minutes. For a Holter monitor, a technician attaches electrodes to your chest and you go about your normal day. The echo involves a gel applied to the chest and a probe moved over the skin; it may take 30–45 minutes. Results are often discussed with you within a week or two.
Treatment
Treatment is personalised, but it generally has three goals: (1) Control the speed of your heartbeat so it doesn’t beat too fast (rate control), (2) Restore a normal rhythm and keep it steady (rhythm control), and (3) Lower the risk of a stroke by preventing clots (anticoagulation). Not everyone needs all three, and your doctor will explain which combination is best for you.
Self-care at home
- Learn to check your own pulse regularly, if your doctor recommends it, and keep a symptom diary
- Limit alcohol – even small amounts can trigger AF in some people; avoid binge drinking
- Manage stress through relaxation, deep breathing, mindfulness, or gentle yoga
- Keep your blood pressure well controlled by following your treatment plan and a healthy lifestyle
- Take any prescribed medicines exactly as directed, and never stop them without speaking to your doctor
Medical treatments
Depending on your symptoms and overall health, your doctor may suggest medicines to slow the heart rate, or to help keep the rhythm normal. To prevent strokes, many people are advised to take a type of medicine called an anticoagulant (sometimes called a blood thinner). This doesn’t actually thin the blood, but makes it less likely to form dangerous clots. Some people also have a procedure: electrical cardioversion (a controlled electric shock under sedation to reset the rhythm) or catheter ablation (a minimally invasive procedure where a thin tube is guided to the heart to destroy tiny areas triggering the abnormal signals). All treatments are discussed with you in detail so you can make an informed choice.
When is surgery considered?
Surgery is rarely the first option. A surgical ‘maze’ procedure can be done if you are having another heart operation anyway. Catheter ablation is a much less invasive alternative and is usually tried before surgery. Your specialist will consider these only if other treatments don’t work well enough or cause side effects.
Living with this condition
Once your treatment plan is in place, most people with AF can go about their daily lives normally. You may need to take medicine every day and attend regular check-ups, perhaps once or twice a year. Know your own body: learn what triggers your symptoms and what helps you feel better. With time, AF often becomes just one part of your overall health management.
Lifestyle tips
- Identify and avoid your personal triggers, such as too much caffeine, alcohol, or poor sleep
- Exercise regularly, but choose activities that feel comfortable. Stop and rest if you develop palpitations or feel unwell, and discuss safe exercise limits with your doctor
- Stop smoking – it’s one of the best things you can do for your heart
- Stay on top of other conditions, like high blood pressure, diabetes, or sleep apnoea
Diet and exercise
A heart-healthy diet includes plenty of fruit, vegetables, whole grains, lean proteins, and healthy fats. Try to limit salt, sugar, and saturated fat. If you take an anticoagulant, be consistent with foods high in vitamin K (like spinach, kale, and broccoli) because they can affect how well the medicine works – don’t cut them out, just eat them in steady amounts and talk to your doctor before making big dietary changes. For exercise, aim for at least 150 minutes of moderate activity each week (such as brisk walking, swimming, or cycling). Start gently if you haven’t been active, and always warm up and cool down.
Mental health and emotional wellbeing
Living with a heart rhythm condition can make you feel anxious, low, or worried about the future. These feelings are normal. Talk to your healthcare team if you feel persistently down or it’s interfering with your life – they can refer you to a counsellor or therapist. If you feel overwhelmed or have thoughts of harming yourself, please reach out to a crisis support line. You are not alone, and support is available.
Prevention
Not all AF can be prevented, especially if it’s linked to age or family history, but you can significantly lower your risk by keeping your heart healthy. This means managing blood pressure, keeping diabetes under control, staying active, maintaining a healthy weight, avoiding heavy drinking, and not smoking.
Vaccines
Staying up to date with recommended vaccines, like the annual flu shot and the pneumonia vaccine if you’re eligible, may help because serious respiratory illnesses can trigger an AF episode. Ask your doctor if these are suitable for you.
Screening programmes
Many health centres offer pulse checks for people over 65. You can also check your own pulse from time to time – simply feel the beat at your wrist or neck and notice if it’s irregular. If you find an irregular rhythm, even if you feel fine, mention it to your doctor.
Complications
If left untreated
- Stroke – because a clot can form in the heart, travel to the brain, and block a blood vessel
- Heart failure – over time, the heart muscle can weaken if it has to pump very fast for long periods
- Reduced blood flow to other organs, which can cause gradual damage
- A poorer quality of life due to persistent fatigue, breathlessness, or anxiety
Long-term outlook
With modern, individually tailored treatment, the outlook for people with AF is excellent. The stroke risk can be reduced by more than 60% with appropriate anticoagulation. Many people live long, healthy lives and remain active. Regular monitoring and a partnership with your healthcare team make all the difference. There is every reason to be hopeful.
Find support
International organisations
Local organisations
- Heart Foundation (Australia) ↗ · Australia
Helplines
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.