What is atrial fibrillation?

Atrial fibrillation is the most common type of heart arrhythmia (irregular heartbeat) that can interrupt the normal flow of blood. This interruption means the condition puts you at risk of blood clots and stroke.

The Centers for Disease Control and Prevention (CDC) estimates that 12.1 million U.S. adults will have atrial fibrillation (AFib or AF) by 2030. The American Heart Association estimates that 2.7 million U.S. adults currently have AFib.

With AFib, the two upper chambers of your heart (atria) are affected. This disrupts blood flow to the ventricles or the lower chambers, and then throughout the rest of your body.

If left untreated, AFib can be deadly.

Atrial fibrillation may be temporary, may come and go, or may be permanent. It’s also most common in adults over the age of 65. But with proper medical care, you can live a normal, active life.

What’s the difference between a healthy and irregular heartbeat? An irregular heartbeat may be too fast, too slow, or inconsistent.

The average heart rate for a healthy person over age 10 is between 60 and 100 beats per minute. If your heart rate climbs higher or drops lower, this may be a sign of an irregular heartbeat.

You may also have the sensation that your heart is skipping a beat, fluttering, or beating too hard. These sensations are known as palpitations.

Some common symptoms of atrial fibrillation include:

These symptoms can come and go based on the severity of your condition.

For example, paroxysmal AFib is a type of atrial fibrillation that resolves on its own without medical intervention. But you may need to take medication to prevent future episodes and potential complications.

Overall, you might experience symptoms of AFib for several minutes or hours at a time. Symptoms that continue over several days could indicate chronic AFib.

Tell a doctor about any symptoms you’re experiencing, especially if there’s a change. It’s also possible to not experience any symptoms at all.

You might not need treatment if you don’t have symptoms, if you don’t have other heart problems, or if the atrial fibrillation stops on its own.

If you do require treatment, a doctor may recommend the following types of medications:

  • beta-blockers to decrease your heart rate
  • calcium channel blockers to relax arterial muscles and decrease overall heart rate
  • sodium or potassium channel blockers to control heart rhythm
  • digitalis glycosides to strengthen your heart contractions
  • blood thinners to prevent blood clots from forming

Non-vitamin K oral anticoagulants (NOACs) are the preferred blood thinners for AFib. They include rivaroxaban (Xarelto) and apixaban (Eliquis).

Generally, the purpose of taking medications for AFib is to normalize your heart rate and promote better heart function overall.

These medications can also prevent possible blood clots in the future, as well as related complications such as heart attack and stroke. Depending on your condition, a doctor may recommend multiple AFib medications.

The heart contains four chambers: two atria and two ventricles.

Atrial fibrillation happens when these chambers don’t work together as they should because of faulty electrical signaling.

Normally, the atria and ventricles contract at the same speed. In atrial fibrillation, the atria and ventricles are out of sync because the atria contract very quickly and irregularly.

The cause of atrial fibrillation isn’t always known. One major factor is stress, including physical and mental or emotional. Stress makes abnormal electrical activity in the heart more likely to occur. It can also make your body tenser and even lead to changes in the speed of your heartbeat.

In some cases, otherwise healthy bodily fluctuations may lead to AFib.

For example, a 2017 study noted that the use of estrogen monotherapy during menopause may increase risk of AFib.

Conditions that can cause damage to the heart and lead to atrial fibrillation include:

Substances and medications may also have an effect, including:

Dehydration may also influence AFib events.

An overall healthy lifestyle may decrease your risk of AFib, but not all causes are preventable. It’s important to tell a doctor about your full health history so they can better pinpoint the causes of your AFib and are better able to treat it.

Some factors may put you at a higher risk for AFib. Some of these can be prevented, while others are genetic.

Talk with a doctor about the following risk factors:

  • increased age (the older you are, the higher your risk)
  • being white
  • being male
  • a family history of atrial fibrillation
  • heart disease
  • structural heart defects
  • congenital heart defects
  • pericarditis
  • history of heart attacks
  • history of heart surgery
  • thyroid conditions
  • metabolic syndrome
  • obesity
  • lung disease
  • diabetes
  • drinking alcohol, especially binge drinking
  • sleep apnea
  • high-dose steroid therapy

Regular medical treatment and checkups with a doctor can help you avoid complications. But if untreated, atrial fibrillation can be serious and even deadly.

Serious complications include heart failure and stroke. Medications and lifestyle habits can both help prevent these in people with AFib.

A stroke happens as a result of a blood clot in the brain. This deprives your brain of oxygen, which can lead to permanent damage. Strokes can also be fatal.

Heart failure occurs when your heart can no longer function properly. AFib can wear down the heart muscle, as the ventricles in the lower chambers attempt to work harder to make up for the lack of blood flow in the upper chambers.

In people with AFib, heart failure develops over time. It’s not a sudden occurrence like a heart attack or stroke might be.

Following your treatment plan can reduce your overall chances of complications due to AFib.

Take all your medications as prescribed by a doctor, and learn about possible AFib complications and their symptoms.

Several different tests can be done to get a better idea of what’s going on with your heart function.

A doctor may use one or more of the following tests to diagnose atrial fibrillation:

  • a physical exam to check your pulse, blood pressure, and lungs
  • an electrocardiogram (EKG), a test that records the electrical impulses of your heart for a few seconds

If atrial fibrillation doesn’t occur during the EKG, a doctor may have you wear a portable EKG monitor or try another type of test.

These tests include:

  • Holter monitor, a small portable device you wear for 24 to 48 hours to monitor your heart
  • event monitor, a device that records your heart only at certain times or when you’re having symptoms of AFib
  • echocardiogram, a noninvasive test that uses sound waves to produce a moving image of your heart
  • transesophageal echocardiogram, an invasive version of an echocardiogram that’s performed by placing a probe in the esophagus
  • stress test, which monitors your heart during exercise
  • chest X-ray to view your heart and lungs
  • blood tests to check for thyroid and metabolic conditions

For chronic or severe AFib, surgery may be a recommended option.

There are different types of surgeries that target the heart muscle to help it pump blood more efficiently. Surgery may also help prevent heart damage.

Types of surgeries that may be used to treat AFib include:

Electrical cardioversion

In this procedure, a brief electrical shock resets the rhythm of your heart contractions.

Catheter ablation

In catheter ablation, a catheter delivers radio waves to the heart to destroy the abnormal tissue that sends out irregular impulses.

Atrioventricular (AV) node ablation

Radio waves destroy the AV node, which connects the atria and ventricles in this procedure. Then the atria can no longer send signals to the ventricles.

A pacemaker is inserted to maintain a regular rhythm.

Maze surgery

This is an invasive surgery that can be either open-heart or through small incisions in the chest, during which the surgeon makes small cuts or burns in the heart’s atria to create a “maze” of scars that will prevent abnormal electrical impulses from reaching other areas of the heart.

This surgery is only used in cases when other treatments were unsuccessful.

A doctor might also recommend other procedures to treat underlying health conditions, such as thyroid or heart diseases, which might be causing your AFib.

Surgery is one treatment method for AFib. Still, medications and lifestyle changes are recommended as first lines of treatment. Your doctor may recommend surgery if your condition is severe.

Most cases of atrial fibrillation can be managed or treated. But atrial fibrillation tends to reoccur and get worse over time.

You can reduce your risk of atrial fibrillation by doing the following:

  • eat a diet that’s rich in fresh fruits and vegetables and low in saturated and trans fat
  • exercise regularly
  • maintain a moderate weight
  • avoid smoking
  • avoid drinking alcohol or only drink small amounts of alcohol occasionally
  • follow a doctor’s advice for treating any underlying health conditions that you have

The most common complications of AFib are strokes and heart failure.

If you have AFib and aren’t taking proper medication, you are five times more likely to have a stroke than people who don’t have AFib.

While there’s no set diet for atrial fibrillation, dietary concerns for AFib focus on heart-healthy foods instead.

An AFib diet will likely include more plant-based foods, such as oats, fruits, and vegetables.

Fish is also a good source of protein, and its omega-3 fatty acid content makes it especially good for the heart.

Foods and substances can make AFib worse. These include:

  • alcohol, especially when binge drinking
  • caffeine, as coffee, soda, tea, and other sources can make your heart work even harder
  • grapefruit, which can interfere with AFib medications
  • gluten, which can increase inflammation if you have an allergy or sensitivity
  • salt and saturated fats
  • vitamin K-rich foods, such as dark leafy greens, as these can interfere with the blood-thinning medication warfarin (Coumadin)

An AFib diet is much like any heart-healthy diet. It focuses on nutrient-rich foods while avoiding irritating substances and low-density foods.

Talk with a doctor about an eating plan for your condition.

Aside from dietary recommendations, a doctor may also suggest certain supplements if you’re low in key nutrients vital to heart health.

Talk with a doctor before taking any additional supplements because these could have side effects or interact with medications.

Some of the supplements used for AFib include:

  • magnesium
  • fish oil
  • coenzyme Q10
  • wenxin keli
  • taurine
  • hawthorn berry

Other natural treatments for AFib include healthy lifestyle habits, like exercise and stress reduction. Exercise is important for your heart health, but you’ll want to take it slow, especially if you’re new to working out.

High intensity exercises, like running, might be too much for people with AFib. But moderate to lower intensity activities, like walking, swimming, and cycling, can still burn calories, strengthen your heart, and alleviate stress.

Since stress can also affect your heart health, it’s crucial to maintain a healthy state of mind. Deep breathing exercises can alleviate everyday stresses, while a yoga class can help you achieve a deeper meditative state (with the bonus of muscle and flexibility).

Even making the time to enjoy a favorite hobby can help you achieve more relaxation and improve heart health.

Natural treatments may help AFib when used together with conventional medical treatments.

More research is needed to determine whether alternative treatments can help alone, so stick to your medical plan. Talk with a doctor how you can effectively incorporate natural treatments into your current AFib treatment plan.

The official guidelines for AFib, according to the American Heart Association, outline the treatment options based on your existing condition and medical history.

A doctor will likely use these when recommending a treatment plan.

In general, a combination of lifestyle habits and medications can help you prevent heart failure and stroke.

A doctor will also classify your AFib to determine if it’s acute (short-term) or chronic (long-term). Age, sex, and overall health will also determine individual risk factors.

Overall, your treatment will focus on:

  • controlling heart rate and rhythm
  • assessing stroke risk
  • assessing risk of bleeding

Sometimes, AFib can be confused with flutters. The symptoms are similar, including rapid heart rate and irregular pulse.

While both affect the same heart chambers and result in arrhythmias, these are two different conditions.

Atrial flutters happen when electrical signals in the heart quicken. The symptoms and risk factors are similar with AFib.

Healthy lifestyle habits and medications can help both conditions. A doctor will help you distinguish between AFib and atrial flutters so you can treat each one accordingly.