A steady heartbeat is a healthy heartbeat, but it’s not uncommon for a heart to get out of rhythm and into atrial fibrillation, especially as you get older. According to the Centers for Disease Control and Prevention, around 10.5 million Americans are impacted by atrial fibrillation, also known as AFib. It is the most common type of irregular heartbeat, although many people don’t know they have it until they experience a health incident.
In this post, Dr. Jonathan Shirazi, cardiologist, Parkview Heart Institute, explains what you should know about the warning signs of AFib, because proper treatment and management can help individuals preserve length and quality of life.
What is AFib?
Some people live with atrial fibrillation; they don’t develop heart failure and have little to no symptoms. They can live well as long as we’re managing their stroke risk.
Atrial fibrillation occurs when the upper chambers of the heart, the atria, get out of rhythm and beat too fast. That irregular heartbeat causes two main problems.
First, when the top of the heart beats too fast, it can make the bottom chambers beat faster and irregularly. If untreated, that can cause long-term damage to the heart tissue, eventually leading to heart failure.
Second, and more immediately, disrupted contraction in the top of the heart can allow blood to pool and even form clots. That can be extremely dangerous because those clots can break off, travel through the bloodstream and block circulation to critical organs. If that happens in the brain, that’s what causes a stroke. About 1 in 6 strokes are caused by AFib, and many patients had no idea that they had it.
Although some people with AFib don’t have noticeable symptoms, most experience:
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Loss of stamina
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Low energy
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Heart palpitations (racing/fluttering)
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Unusual shortness of breath
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Lightheadedness
Anyone experiencing chest pain or stroke-like symptoms should seek emergency help immediately.
Fitness trackers or other wearables can help identify an irregular rhythm. Although they’re not designed specifically for detecting AFib, if a wearable gives you a warning about an unusual heart rate, don’t ignore it and be sure to discuss it with your physician.
Risk factors
AFib can impact anyone, but like most medical conditions, certain risk factors might increase your odds of developing AFib.
There are “non-modifiable” risk factors – things you can’t control – while there are other risks that you can actively try to reduce.
On the non-modifiable side, age and genetics are two main risks that increase the chance of developing AFib. Many heart problems, including AFib, have a genetic component, making family history a warning sign. Older individuals are also at higher risk because the body is weaker and therefore more likely to experience complications.
As far as modifiable risk factors, common chronic conditions like high blood pressure and diabetes, as well as thyroid conditions, increase the risk of atrial fibrillation, particularly if these conditions are not well managed.
But another big risk factor is alcohol. AFib has been linked with alcohol consumption, even if a person is only drinking one or two drinks at a time.
Reducing alcohol consumption is a universal improvement even for people who don’t drink a lot of alcohol. When alcohol is metabolized, one byproduct is acetaldehyde, a major irritant to the heart's upper chambers.
Prevention
Reducing one’s risk for AFib overlaps with the advice for prevention of most cardiovascular diseases and includes:
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Eating a healthy diet
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Exercising
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Losing weight
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Reducing or eliminating alcohol consumption
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Managing chronic conditions, such as high blood pressure
Research on health supplements is mixed and not high quality. Still, vitamins with low doses of magnesium and/or potassium may be beneficial. In contrast, fish oil supplements, which are recommended for some health conditions, appear to have a more negative impact when it comes to AFib.
A few less common lifestyle changes can help, too. Take note if your body reacts oddly after a large meal or after eating food that’s really hot or really cold, as that can sometimes trigger an irregular heartbeat.
Getting good sleep is also good for your heart. Sleep apnea is a risk factor for many heart conditions, but even people who just suffer multiple consecutive days of poor sleep can run into issues. For individuals who don’t have actual apnea, even stacking several bad nights of sleep will make them much more likely to develop other rhythms.
And lastly, good news for coffee drinkers, a couple of cups of coffee have been correlated with lower AFib risk. But there’s a limit. While two cups may actually prevent AFib according to large studies of people, you should be under 100 milligrams of caffeine per day, as exceeding that may make AFib more likely.
Treatment
For people who do develop AFib, managing the condition depends on the severity of the symptoms and what a patient’s goals are. But treatment breaks down into two parts.
One component is reducing stroke risk. Regardless of anything else we’re going to try to do, the first step is always lowering the stroke risk, which typically involves using an anticoagulant.
For patients who cannot safely take anticoagulation long term, your doctor may consider a procedure called Watchman™, which implants a device in the area of the heart where most clots form to eliminate the need for anticoagulant medicine.
Options for restoring normal heart rhythm can vary from patient to patient. Some people who experience few symptoms can live comfortably and safely just by managing their stroke risk; others may need electrical stimulation to restore their normal rhythm; some may consider ablation, a surgery to lower atrial fibrillation.
Patients should discuss their options with their cardiologist to determine what intervention is best for them. Parkview has received the American Heart Association’s Get With The Guidelines® Gold Plus award for using evidence-based best practices in AFib care for three consecutive years, as well as the AHA’s Commitment to Quality Award in 2025.
Final thoughts
With the Centers for Disease Control and Prevention (CDC) estimating the U.S. could see up to 12 million individuals with AFib by 2050, knowing the signs and seeking treatment early can make AFib manageable.
Atrial fibrillation is common and can be dangerous or even deadly if left untreated. But if you're diagnosed, work with your cardiologist and stick to your treatment plan; that can drastically improve the length and quality of your life.
