What is atrial fibrillation?

Atrial fibrillation (AFib) is a heart rhythm disorder (arrhythmia) where the upper chambers of the heart (atria) beat irregularly. This disrupts normal blood flow to the lower chambers (ventricles), increasing the risk of blood clots, stroke, and other heart-related complications.

What are the symptoms of atrial fibrillation?

AFib symptoms can vary—some people may not notice anything, while others feel significant discomfort.

Common symptoms of atrial fibrillation include:

• Irregular or rapid heartbeat (palpitations)
• Fatigue or weakness, especially during activity
• Shortness of breath, even at rest
• Dizziness or lightheadedness
• Chest discomfort or pain
• Reduced exercise capacity
• Fainting or near-fainting (less common)

Sometimes AFib is only discovered during a routine health check, even without obvious symptoms.

What causes atrial fibrillation?

AFib can be triggered by multiple health conditions or lifestyle factors affecting the heart’s electrical system.

Common causes of atrial fibrillation:

• High blood pressure (hypertension)
• Coronary artery disease
• Heart valve problems
• Previous heart attack or heart surgery
• Congenital heart defects
• Heart inflammation (myocarditis or pericarditis)
• Lung disease, including pneumonia

Who is at risk of atrial fibrillation?

Certain risk factors make AFib more likely:

• Age (especially over 60)
• Obesity
• Diabetes
• Sleep apnea
• Thyroid disorders (especially hyperthyroidism)
• Smoking or heavy alcohol use
• Family history of AFib
• Chronic stress or long-term illness

What are the long-term complications of atrial fibrillation?

If untreated, atrial fibrillation can lead to serious, life-threatening complications:

1. Stroke – AFib allows blood to pool in the atria, forming clots that may travel to the brain, causing an ischemic stroke.
2. Heart failure – Over time, irregular and rapid heartbeats weaken the heart muscle, leading to heart failure.
3. Cognitive decline & dementia – AFib has been linked to memory loss and dementia due to reduced brain blood flow and silent strokes.
4. Cardiomyopathy – Prolonged rapid heart rhythms can enlarge and weaken the heart muscle.
5. Blood clots in other organs – Clots can also affect the lungs, kidneys, or other organs, causing severe damage.

How is atrial fibrillation diagnosed?

AFib is often detected during a routine exam or when investigating symptoms. Diagnosis usually involves:

• Medical history & physical exam
• Electrocardiogram (ECG) – the key test to detect irregular heart rhythms
• Holter monitor – continuous ECG recording for 24–48 hours
• Implantable loop recorder – long-term rhythm monitoring
• Echocardiogram – ultrasound to assess heart structure and function
• Blood tests – check for thyroid or other underlying conditions
• Exercise stress test – evaluates heart performance under activity
• Chest X-ray – checks for related lung or heart issues

Can atrial fibrillation be cured?

AFib is not always permanently curable, but it can be effectively managed to control symptoms and reduce complications.

Treatment options for atrial fibrillation include:

• Medications to regulate heart rate/rhythm and prevent clots
• Cardioversion – an electrical shock to restore normal rhythm
• Catheter ablation – destroying abnormal heart tissue that triggers irregular signals
• Lifestyle changes – reducing stress, limiting alcohol, quitting smoking, managing weight, and treating sleep apnea
• Surgery – in severe or persistent cases

In some cases, AFib caused by reversible conditions can resolve completely.