Atrial fibrillation isn’t always symptomatic, but the condition can sometimes cause heart palpitations or chest pain. Learn about other symptoms of AFib and discover a variety of treatments.
The human heart beats many times throughout the course of a typical lifetime.
You rarely have any conscious awareness of the heart in action, as blood quietly swishes through the muscle’s chambers. Electrical impulses keep the heart beating at a steady pace, ensuring that blood is consistently pumped around your body.
Sometimes, there’s a problem with your heart rate. Your heart may beat too quickly, too slowly, or irregularly. This is called an arrhythmia. The most common type of arrhythmia is atrial fibrillation (AFib).
Diagnosis of AFib is important because the condition can increase your risk of stroke.
Many people with AFib don’t have any symptoms. Others may feel a sensation of fluttering, skipping, or jumping in their chest. These are known as palpitations.
Read on to learn more about palpitations and other symptoms of AFib.
There are four chambers in your heart. The right and left atria are at the top. The right and left ventricles are at the bottom.
The four chambers normally work in smooth coordination to circulate blood throughout your body
In a healthy heart, the right atrium receives low oxygen blood from the body. The blood travels to the right ventricle, where it gets an oxygen boost from the lungs. Then it travels into the left atrium. After that, the blood is pumped into the left ventricle, where it sends oxygen rich blood throughout the body.
If you could see your heart at the time of your AFib, the muscle might remind you more of a nervous rabbit than the strong, self-assured lion it is normally.
In an episode of AFib, the atria don’t beat in a normal way. Instead, they race or quiver. This means they’re not able to properly fill with blood, and forward blood flow into the ventricles is limited. Blood may pool in the atria, increasing the risk of a blood clot. If the clot gets sent out to the brain, it can cause stroke.
Almost everyone has experienced heart palpitations at some point. Palpitations can be a response to big emotions, nicotine, too much caffeine, or other triggers. In some cases, they’re a symptom of AFib.
A palpitation feels very strange, like something indefinable is wrong in your chest. You may experience a mild fluttering sensation or suddenly become aware that your heart skipped a beat. This can last for a few seconds or a few minutes.
Not everyone with AFib will have symptoms though. It’s estimated that at least one-third of people with AFib have no symptoms.
A 2012 study also found that older adults often had AFib without palpitations. In the study, emergency responders assessed 27,841 people who were looking for medical services. The study participants were given portable electrocardiogram (EKG) devices. An EKG is a test to measure the heart’s electrical signals.
Ultimately, 11.67 percent of people had AFib diagnosed.
Older people were less likely to experience typical AFib symptoms than younger people. Eighty-six to 91 percent of people over 70 years with AFib had symptoms other than palpitations. This means only 9 to 15 percent of them had palpitations. In comparison, 20 to 52 percent of people under 50 years had symptoms other than palpitations, meaning that 48 to 80 percent had palpitations.
What AFib feels like
“It really felt like I had a fish flopping around in my chest where my heart should be. It felt like when you are exercising and you can’t breathe. Or palpitations can be subtle. They can feel like butterflies.”
— Mellanie True Hills, founder of StopAfib.org
If you’re not asymptomatic, possible symptoms of AFib can also include:
- chest pain
- shortness of breath
- swelling in the feet and ankles, which may indicate heart issues
If you have symptoms of AFib, speak with a healthcare professional as soon as possible.
Your AFib risk
Healthcare professionals will often counsel people on conditions that may predispose them to AFib, such as high blood pressure, sleep apnea, or heart failure.
They may closely monitor cholesterol and blood sugar levels too.
Questions a healthcare professional may ask before diagnosing AFib include:
- Does your chest hurt?
- Do you have high blood pressure, diabetes, a thyroid condition, heart disease, or lung disease? Do any of your family members have these conditions?
- Do any of your family members have AFib?
- Do you smoke, drink alcohol, or use drugs or caffeine?
- Have you ever had symptoms of stroke or transient ischemic attack (TIA)?
- A TIA, or ministroke, occurs when blood flow to the brain is blocked for a few minutes. A TIA has symptoms similar to those of stroke, but it doesn’t last as long.
A healthcare professional will want to assess your overall risk of stroke. Diagnosis of AFib is an important step toward beginning treatment to prevent stroke.
If a healthcare professional diagnoses AFib, they’ll assess your other risk factors for stroke and counsel you on the best strategies for stroke prevention. If you have multiple stroke risk factors, the treatment for AFib may be different.
Risk factors include:
- a history of stroke or TIA
- coronary artery disease
- heart attack
- heart failure
- older age
Stroke symptoms or TIA symptoms can include:
- loss of balance
- a sudden and intense headache
- loss of feeling or numbness on one side of your body
- having trouble talking
- feeling dizzy
- loss of vision in one or both eyes
If you have any of these symptoms, get medical attention.
There are a few ways to diagnose AFib.
If you have persistent AFib symptoms, a healthcare professional can confirm your diagnosis with an EKG.
For the EKG, you’ll lie quietly and have several sensors stuck to your chest, arms, and legs. The EKG is used to detect the electrical impulses sent out by the heart. It can show if there’s anything unusual about your heart rate.
For people who are asymptomatic, AFib can turn up during an EKG that’s set up for another purpose. If you have other risk factors for stroke, you may go for a routine EKG to check your heart rate. Some people may also notice an irregular heart rate while wearing a smartwatch or heart rate monitor.
If your AFib symptoms are more sporadic but occur frequently, you can wear a small device called a Holter monitor. It’s like a portable EKG machine.
You typically wear the monitor for 24 to 72 hours, although some monitors can be worn for 5 to 7 days. Over this period, the monitor captures information about your heart’s behavior.
An event monitor is another type of portable EKG machine. A Holter monitor records your heart rate continuously, while an event monitor only records your heart rate when you activate it.
In some cases, event monitors will automatically record anything unusual about your heart rate. This is helpful for someone who has paroxysmal AFib, which causes sporadic and infrequent symptoms over a period of time.
An event monitor can be worn for as long as
If exercise triggers your AFib, you’ll be scheduled for a treadmill test. This test allows a healthcare professional to see how exercise affects your heart rate.
If you’ve had AFib diagnosed, you may have an echocardiogram done. This imaging test will reveal any changes in the valves or structure of your heart.
Treatment is recommended whether or not you have symptoms of AFib. The goal of treatment is to both manage symptoms and reduce the risk of stroke.
Your specific treatment will depend on your overall risk of stroke and other health conditions. Of utmost importance is that people who are symptomatic take medications to reduce their risk of stroke.
For blood clot prevention
Prescription blood thinners help prevent stroke by reducing blood clotting. They may be used if you have other risk factors for stroke.
If you don’t have other risk factors for stroke, baby aspirin is an option. It can also thin the blood.
For asymptomatic AFib
If you’re asymptomatic, the best treatment strategies may include stroke prevention and medication to prevent the heart rate from going too fast. A healthcare professional will go over your options with you.
Beta-blockers and calcium channel blockers work to slow your heart rate, which reduces stress on your heart. They’re also used to lower blood pressure.
On rare occasions, a doctor may suggest medications or procedures to get you out of AFib.
For symptomatic AFib
If you’re symptomatic, a doctor will discuss strategies to keep you out of AFib, such as:
- Antiarrhythmics. These medications help to restore a normal heart rate.
- Cardioversion therapy. In cardioversion therapy, a doctor sends a controlled electrical current to your heart to normalize your heart rate.
- Pacemaker. A pacemaker is a small device that’s implanted in your heart. It sends electrical impulses to keep the heart rate normal and consistent.
- Cardiac ablation. First, testing is done to identify which parts of the heart are sending irregular electrical impulses. Then these parts are surgically burned away, allowing the heart rate to stabilize. Learn more about cardiac ablation.
If you experience AFib, get prompt medical care, even if your symptoms are subtle. Feeling faint, for instance, can be enough of a reason to look for help.
An irregular heart rate can lead to inefficient blood flow. Your blood pressure can fall, bringing about the risk of heart failure. Over time, an irregular heart rate can also stress and weaken the heart. A weak heart is unable to pump enough blood to meet the body’s needs.
Also, because blood doesn’t empty completely from the atria, dangerous clots may form and break off. If the blood clots travel through the ventricles and reach the brain, you could experience stroke.
A prompt diagnosis will help ensure you get proper treatment and can avoid these complications.