Yes, you can have Atrial Fibrillation (AFib) with normal blood pressure, though high blood pressure (hypertension) is a major risk factor, but AFib can also occur in people with healthy blood pressure, and AFib itself can sometimes lead to low blood pressure (hypotension) due to the heart's inefficient pumping. Other factors like heart disease, thyroid issues, obesity, sleep apnea, and even genetics can trigger AFib, and some people develop it without a clear cause.
While it is very common for people with atrial fibrillation to have high blood pressure, not everyone with AFib has hypertension.
Current guidelines recommend target systolic blood pressure levels of <130 mmHg [1] or between 120–129/70–79 mmHg [2] for patients with atrial fibrillation.
The 30-second rule in atrial fibrillation (AFib) is a widely used, though debated, guideline defining an AFib episode as an irregularly irregular heart rhythm lasting at least 30 seconds on an ECG, used to distinguish it from shorter, less significant atrial arrhythmias and help guide diagnosis and treatment, particularly for stroke risk and ablation success. While a standard for trials and device monitoring, newer research suggests shorter runs of AF might still be clinically important, prompting ongoing discussion about whether this threshold accurately reflects stroke risk and overall AF burden.
Symptoms of atrial fibrillation
If you can't feel a pulse on your wrist, try checking under your jaw. Be careful as this makes some people lightheaded. If your pulse feels irregular, try checking for 60 seconds instead. The beat should be steady and regular.
More common symptoms of AFib
Heart surgery or stress due to surgery or sickness also may cause AFib. Some people who have atrial fibrillation have no known heart disease or heart damage. Lifestyle habits that can send the heart into AFib may include: Drinking too much alcohol or caffeine.
The sensation that your heart is fluttering, quivering, or pounding is perhaps the most common symptom of AFib. Many people describe feeling like a fish is flopping or butterflies are taking flight in their chest.
When atrial fibrillation occurs, the upper heart chambers beat in an unorganized rhythm. An A-fib heart rate is usually rapid, resulting in 100-200 beats per minute rather than the normal range of 60-100 beats per minute. If left untreated, A-fib can lead to chronic fatigue, congestive heart failure or stroke.
If you have atrial fibrillation (AFib), you should avoid triggers like excessive alcohol, caffeine, smoking, and stimulants, manage stress, limit salt, get enough sleep, and talk to your doctor about certain medications (like decongestants) and exercise routines, stopping immediately if you feel dizzy or short of breath to prevent episodes and complications like stroke.
Hypertension is a leading cause of AFib, a serious heart rhythm disorder that often goes unnoticed but increases the risk of stroke2. OMRON blood pressure monitors with AFib Screening Technology are clinically validated to detect the possibility of AFib while taking your routine blood pressure measurement.
Pulsed field ablation: A safer, faster AFib treatment
For many people with atrial fibrillation, the most effective treatment includes catheter ablation, a procedure in which the abnormal cells responsible for triggering the arrhythmia are eliminated and a normal heart rhythm is restored.
Conclusions: Left atrial thrombus does occur in patients with acute atrial fibrillation < 3 days in duration. The frequency of left atrial thrombus in patients with recent emboli is comparable between those with acute and chronic atrial fibrillation.
Your age and health are factors: People over 65 and with pre-existing heart or thyroid conditions are more likely to have AFib. Listen to your heartbeat: Your heartbeat will be very erratic with AFib, while with palpitations it'll beat fast but in a steady pattern and slowly return to normal.
Here are nine triggers that frequently go unnoticed but could be contributing to your Afib episodes.
Conditions That Can Look Like AFib
Everyone is different when it comes to comfort during AFib episodes. Some find lying down helpful, while others might feel worse. For example, people with orthopnea might find sitting upright more comfortable. It's important to understand these differences to find the best rest position for each person.
Difficulty breathing, especially when lying down or when exercising. Chest pain. Dizziness or fainting. Heart palpitations, or the feeling that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast.
Symptoms of AFib include “palpitations, shortness of breath, dizziness or lightheadedness and maybe some chest pressure,” Dr. Dominic said. But “the most common symptom of AFib—which is the most underappreciated symptom—is fatigue.”
Increased need to urinate – Particularly during atrial fibrillation episodes due to the additional flow of blood through the kidneys.
Atrial fibrillation is a type of irregular heartbeat. It's commonly called AFib. The relationship between AFib and stress, anxiety and depression is complex. Some studies say there's a link between symptoms of these mental health conditions and the risk of AFib.
Tests to diagnose atrial fibrillation (AFib) may include:
The American College of Cardiology and the American Heart Association introduced new guidelines and created four categories—paroxysmal, persistent, long-standing persistent, and permanent AFib.
Sleeping on the right side is often recommended for individuals with AFib. This sleeping position helps ease the strain on the heart and supports better blood flow. It may also lower the risk of acid reflux, which can trigger nighttime palpitations.