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Atrial fibrillation is a type of irregular or rapid heartbeat (arrhythmia). In atrial fibrillation, the top part of the heart (atria) beats in an irregular pattern. This makes the heart unable to pump blood normally and effectively.

The goal of treatment is to prevent blood clots from forming, control your heart rate, or restore your heartbeat to a normal rhythm. If this condition is not treated, it can cause serious problems, such as a weakened heart muscle (cardiomyopathy) or a stroke.

What are the causes?

This condition is often caused by medical conditions that damage the heart’s electrical system. These include:

  • High blood pressure (hypertension). This is the most common cause.

  • Certain heart problems or conditions, such as heart failure, coronary artery disease, heart valve problems, or heart surgery.

  • Diabetes.

  • Overactive thyroid (hyperthyroidism).

  • Obesity.

  • Chronic kidney disease.

In some cases, the cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in:

  • Older people.

  • People who smoke.

  • Athletes who do endurance exercise.

  • People who have a family history of atrial fibrillation.

  • Men.

  • People who use illegal drugs.

  • People who drink a lot of alcohol.

  • People who have lung conditions, such as emphysema, pneumonia, or COPD.

  • People who have obstructive sleep apnoea.

What are the signs or symptoms?

Symptoms of this condition include:

  • A feeling that your heart is racing or beating irregularly.

  • Discomfort or pain in your chest.

  • Shortness of breath.

  • Sudden light-headedness or weakness.

  • Tiring easily during exercise or activity.

  • Fatigue.

  • Syncope (fainting).

  • Sweating.

In some cases, there are no symptoms.

How is this diagnosed?

Your healthcare provider may detect atrial fibrillation when taking your pulse. If detected, this condition may be diagnosed with:

  • An electrocardiogram (ECG) to check electrical signals of the heart.

  • An ambulatory cardiac monitor to record your heart’s activity for a few days.

  • A transthoracic echocardiogram (TTE) to create pictures of your heart.

  • A transoesophageal echocardiogram (TOE) to create even closer pictures of your heart.

  • A stress test to check your blood supply while you exercise.

  • Imaging tests, such as a CT scan or chest X-ray.

  • Blood tests.

How is this treated?

Treatment depends on underlying conditions and how you feel when you experience atrial fibrillation. This condition may be treated with:

  • Medicines to prevent blood clots or to treat heart rate or heart rhythm problems.

  • Electrical cardioversion to reset the heart’s rhythm.

  • A pacemaker to correct abnormal heart rhythm.

  • Ablation to remove the heart tissue that sends abnormal signals.

  • Left atrial appendage closure to seal the area where blood clots can form.

In some cases, underlying conditions will be treated.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as instructed by your healthcare provider.

  • Do not take any new medicines without talking to your healthcare provider.

  • If you are taking blood thinners:

    • Talk with your healthcare provider before you take any medicines that contain aspirin or NSAIDs, such as ibuprofen. These medicines increase your risk for dangerous bleeding.

    • Take your medicine exactly as told, at the same time every day.

    • Avoid activities that could cause injury or bruising, and follow instructions about how to prevent falls.

    • Wear a medical alert bracelet or carry a card that lists what medicines you take.

Lifestyle

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  • Do not use any products that contain nicotine or tobacco, such as cigarettes, e-cigarettes and chewing tobacco. If you need help quitting, ask your healthcare provider.

  • Eating heart-healthy foods. Talk with a dietitian to make an eating plan that is right for you.

  • Exercise regularly as instructed by your healthcare provider.

  • Do not drink alcohol.

  • Lose weight if you are overweight.

  • Do not use illegal drugs, including cannabis.

General instructions

  • If you have obstructive sleep apnoea, manage your condition as told by your healthcare provider.

  • Do not use diet pills unless your healthcare provider approves. Diet pills may make heart problems worse.

  • Keep all follow-up appointments as instructed by your healthcare provider. This is important.

Contact a healthcare provider if you:

  • Notice a change in the rate, rhythm, or strength of your heartbeat.

  • Are taking a blood thinner and you notice more bruising.

  • Tire more easily when you exercise or do heavy work.

  • Have a sudden change in weight.

Get help right away if you have:

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  • Chest pain, abdominal pain, sweating, or weakness.

  • Trouble breathing.

  • Side effects of blood thinners, such as blood in your vomit, stool, or urine, or bleeding that cannot stop.

  • Any symptoms of a stroke. “BE FAST” is an easy way to remember the main warning signs of a stroke:

    • B – Balance. Signs are dizziness, sudden trouble walking, or loss of balance.

    • E – Eyes. Signs are trouble seeing or a sudden change in vision.

    • F – Face. Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.

    • A – Arms. Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.

    • S – Speech. Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.

    • T – Time. Time to call emergency services. Write down what time symptoms started.

  • Other signs of a stroke, such as:

    • A sudden, severe headache with no known cause.

    • Nausea or vomiting.

    • Seizure.

These symptoms may represent a serious problem which is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services. Do not drive yourself to the hospital.

Summary

  • Atrial fibrillation is a type of irregular or rapid heartbeat (arrhythmia).

  • Symptoms include a feeling that your heart is beating fast or irregularly.

  • You may be given medicines to prevent blood clots or to treat heart rate or heart rhythm problems.

  • Get help right away if you have signs or symptoms of a stroke.

  • Get help right away if you cannot catch your breath or have chest pain or pressure.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.