Atrial Fibrillation: Symptoms, Risks, and What to Do
Atrial fibrillation is a common heart condition that causes an irregular, often abnormally fast heartbeat. In this guide, we discuss the symptoms, causes and treatment and how the condition can be connected to high blood pressure.
Call 999 immediately if you are experiencing chest pain, chest tightness, discomfort in one or both arms or shoulders, or if you feel weak, light-headed, or faint.
What is atrial fibrillation, or AFib?
Atrial fibrillation, abbreviated as AFib or AF, is a common condition that causes an irregular, often abnormally fast heart rate. Some people can feel their heart ‘racing’, or experience a fluttering feeling in their chest, known as palpitations.
It may come and go, or it may be persistent. While it’s not life-threatening, it’s considered serious because in some cases it can lead to heart failure or stroke.
Types of Atrial Fibrillation
There are three types of atrial fibrillation:
- Paroxysmal atrial fibrillation is when AFib symptoms resolve on their own within 7 days. Usually, paroxysmal atrial fibrillation will resolve within 24 hours.
- Persistent AFib symptoms are similar to paroxysmal, but medical treatment is required.
- Long-standing persistent AFib lasts more than a year and does not respond to treatment.
- Permanent atrial fibrillation does not go away
Atrial fibrillation symptoms
Heart palpitations are the most obvious symptom of atrial fibrillation. You may find your heart feels like it’s pounding, fluttering or beating irregularly, for a few seconds or even minutes.
Other atrial fibrillation symptoms include:
- Feeling tired or lethargic
- Finding it harder to exercise
- Shortness of breath
- Feeling faint or lightheaded
- Chest pains
Call 999 if you:
If these symptoms last more than 15 minutes, you could be having a heart attack. Call 999 immediately.
Atrial fibrillation symptoms at night
Nighttime AFib symptoms can look a little bit different from daytime symptoms. Inform your doctor if you have been experiencing any of these symptoms while you sleep:
- Heavy breathing during sleep
- Night waking with a weird feeling in your chest
- Night sweats
- Waking with feelings of anxiousness
AFib vs Arrhythmia
An irregular heartbeat is considered an arrhythmia when the heartbeat is too slow, too fast, or otherwise irregular. AFib is an irregular heartbeat in the two atria of the heart. With AFib, blood does not efficiently flow into the lower heart chambers.
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While the exact cause of atrial fibrillation isn’t known, it’s more common with age and in people with other cardiovascular conditions, such as:
- High blood pressure
- Atherosclerosis (plaque in the arteries)
- Heart valve disease
- Congenital heart disease
- Coronary heart disease
- Cardiomyopathy (a condition affecting the heart muscles)
- Pericarditis (inflammation of the tissue surrounding the heart)
Atrial fibrillation is also associated with other medical conditions, including pneumonia, asthma, chronic obstructive pulmonary disease (COPD), lung cancer and pulmonary embolism.
But many people with atrial fibrillation won’t have any pre-existing conditions or risk factors – it can even affect those who are physically very fit.
Diagnosis and treatment
Checking your pulse can give you a good indication of whether you have atrial fibrillation, but your general practitioner will investigate thoroughly before making a diagnosis.
If your doctor suspects you have atrial fibrillation, they may send you for an electrocardiogram (ECG) and refer you to a heart specialist for further testing, which may include a combination of chest x-ray, echocardiogram (EKG), or blood tests.
Once you have an atrial fibrillation diagnosis, you’ll be given a treatment plan. If your healthcare team can identify a cause, such as an overactive thyroid gland, for example, you may only need treatment for the root cause. If testing does not reveal an underlying cause, the treatment options are:
- Modification of lifestyle or risk factors
- Medicines to reduce the risk of a stroke
- Medications to control atrial fibrillation
- Cardioversion (electric shock treatment)
- Catheter ablation
AFib and High Blood Pressure
While atrial fibrillation and high blood pressure are two separate conditions, they are interlinked. High blood pressure is a risk factor for atrial fibrillation, and those with high blood pressure in middle age are at increased risk for atrial fibrillation later in life.
Both conditions increase the risk of stroke. In hypertension, the force of blood pushing against the arteries is too high, causing gradual damage to the arteries and the possibility that a weakened blood vessel may rupture in or near the brain. With atrial fibrillation, the rapid heartbeat allows blood to pool in the heart, which can cause clots to form and travel to the brain.
But even if you’re among the millions of people with high blood pressure or atrial fibrillation, there’s plenty you can do to minimise your chances of having a stroke. Take your medication as prescribed and follow the British Heart Foundation’s lifestyle recommendations:
- Eat healthily, swapping to lower fat options and lean meats
- Be physically active, aiming for a brisk half-hour walk every day
- Quit smoking: 20 minutes after stopping, heart rate and blood pressure return to normal
- Cut down on alcohol by switching to alcohol-free drinks or halving your units
- Control high blood pressure by cutting down on salt and managing stress
- Work on your cholesterol levels by eating more fibre and fewer saturated fats
- Be mindful of your blood sugar levels, swapping sugary snacks for fruits and choose sugar-free drinks
To get a sense of your risk, it’s a good idea to check your blood pressure regularly. You can schedule frequent checks with your doctor, but since office visits aren’t always convenient, a lot of people choose to monitor with a home blood pressure cuff or with continuous monitoring.
Continuous monitoring with a specialized wristband is the most efficient and effortless way to keep tabs on your blood pressure throughout the day and night. If you are continuously monitoring and keeping track of your lifestyle changes, you can get a sense of what’s working and where you may need to make adjustments.
FAQs About Atrial Fibrillation
How long can you live with an irregular heartbeat?
Atrial fibrillation can increase the risk of blood clots, stroke, and heart failure. But, if you and your doctor are taking steps to manage your cardiovascular health, AFib won’t necessarily shorten your lifespan.
When should I be worried about irregular heartbeat?
If you notice irregular heartbeat, you should discuss it with your doctor. If your symptoms just started or are getting worse, if they last more than a few minutes, or if you are also experiencing chest pain, pressure, or tightness, call 999 and seek medical attention immediately.
What is a normal heart rate?
A normal resting heart rate for a healthy adult should be between 60 and 100 beats a minute. Several factors can alter your heart rate, such as medications, age, stress, and even your menstrual cycle. You can check your heart rate by finding your pulse in your neck or wrist, and counting beats per minute.
How to check your pulse rate
- Find your pulse in your wrist or neck. Place your index and middle fingers on the pulse point. No need to press hard—if you can feel the beat, you’re ready.
- Set a timer for one minute (60 seconds).
Count how many beats you feel in one minute. That’s your heart rate in beats per minute.
Is atrial fibrillation hereditary?
Atrial fibrillitaion can run in families, or the condition can be isolated to one person in the family. AFib that runs in families is known as familial atrial fibrillation.
What is a dangerous heart rate with AFib?
In atrial fibrillation, the heart rate can climb to 100-200 beats per minute. If a rapid heart rate lasts for more than a few minutes, call your doctor immediately.
Most of us would admit we could be doing more to look after our health, and the recommendations above apply to us all. But if you’ve been diagnosed with hypertension or atrial fibrillation, it’s even more important to make healthy choices and minimise the risks. Monitoring your heart rate and blood pressure regularly and knowing your triggers is a great first step.
Disclaimer: This article is for informational purposes only and does not contain medical advice, and is not a replacement for medical advice. The information in this article is not intended to diagnose, treat, cure, or prevent any disease. Talk to a qualified medical professional before making any changes to your health regimen.
NHS Overview: Atrial Firbillation, May 17, 2021 — https://www.nhs.uk/atrial-fibrillation
Atrial fibrillation (AF) : causes, symptoms and treatments, March 2021 — https://www.bhf.org.uk/atrial-fibrillation
High Blood Pressure, AFib and Your Risk of Stroke, July 31, 2015 — https://www.heart.org/health-topics/high-blood-pressure-afib-and-your-risk-of-stroke
Complications of Atrial Fibrillation, February 22, 2023 — https://www.webmd.com/heart-disease-afib-complications
How do I check someone’s pulse? June 16, 2022 — https://www.nhs.uk/common-health-questions-how-do-i-check-someones-pulse
Does atrial fibrillation run in families? October 11, 2022 — https://www.mayoclinic.org/expert-answers-atrial-fibrillation-genetics
British Health Foundation: Healthy Living, Accessed February 27, 2023 — https://www.bhf.org.uk/support-healthy-living