Atrial fibrillation

Atrial fibrillation (AF) is a common irregular heart rhythm (arrhythmia).

In atrial fibrillation, the top chambers of the heart (the atria) can quiver or twitch (fibrillate). This causes the heart to beat irregularly.

Atrial fibrillation is not usually life threatening in itself. Many people live normal healthy lives with this condition. But, in some cases treatment will be needed or recommended.

Risks of atrial fibrillation

For some people, atrial fibrillation could create blood clots in the heart that may lead to a stroke. The risk of this is influenced by other factors, including:

age (being older)
whether you have high blood pressure
heart failure
diabetes
a previous history of blood clots

Lifestyle changes and treatment can reduce this risk.

Symptoms of atrial fibrillation

Some people with atrial fibrillation have no symptoms. Many will not even be aware that they have an irregular heartbeat. Sometimes it’s only discovered during routine tests or investigations for another condition.

The most obvious symptom of atrial fibrillation is palpitations. Palpitation is an awareness of your heartbeat. For example, your heart might feel like it’s pounding, fluttering or beating irregularly. You may feel these sensations in your chest, throat or neck.

You may feel that your heart is beating fast, even when you’re not exercising.

You may also experience:

tiredness
breathlessness
dizziness
feeling faint
chest discomfort or pain

Phone 999 or go to A&E if:

You or someone else has heart palpitations and:

dizziness
sudden shortness of breath
chest pain
loses consciousness

Types of atrial fibrillation

Atrial fibrillation can be:

intermittent (paroxysmal) – it lasts for a few minutes or hours
persistent – episode lasts for more than 7 days
long-term persistent – it’s continuous and can last over a year
permanent – it does not go away

Paroxysmal atrial fibrillation

Atrial fibrillation can come and go, lasting between a few minutes or a few hours. This is known as paroxysmal atrial fibrillation. This means it can be hard to detect paroxysmal atrial fibrillation.

A portable or ambulatory electrocardiogram (ECG) recorder can help to diagnose paroxysmal atrial fibrillation. This is because it records your heart rate for 24 hours or longer.

Diagnosing atrial fibrillation

In some cases, atrial fibrillation can be detected by a:

pulse check
single lead ECG device – such as a single sensor attached to the chest or contained in a watch strap

If your doctor thinks you may have atrial fibrillation, you may be referred for other tests. These can include an:

12 lead ECG – a more detailed recording of the heart rhythm from 12 sensors attached to the chest
echocardiogram

You may not need treatment if your doctor has assessed your health and your heart rate returns to normal. Your doctor will decide if you would benefit from any treatment.

How to check your pulse

This video shows you how to check your pulse.

Treatment for atrial fibrillation

Anticoagulant medicines prevent harmful blood clots from forming. They are sometimes called blood thinners, but they do not actually thin the blood. Instead they increase the time it takes for your blood to form a clot.

People with atrial fibrillation who are at risk of having a stroke may be prescribed anticoagulant medication. This is to reduce the risk of blood clots forming within the heart which can increase the risk of stroke.

Other treatments for atrial fibrillation focus on controlling the rate and rhythm of the heart. They include: