Atrial fibrillation (AFib) is diagnosed through a combination of medical history, physical exam (checking pulse/heart rate), and the key test: an electrocardiogram (ECG/EKG), which records the heart's electrical signals. Since AFib can come and go, doctors often use portable monitors like Holter monitors, event recorders, or implantable devices to catch episodes over longer periods, along with blood tests and echocardiograms to find underlying causes like thyroid issues or heart disease.
An ECG is the main test for diagnosing atrial fibrillation. Holter monitor. This is a small, portable ECG device. It records the heart's activity.
Symptoms of atrial fibrillation (AFib) may include:
To diagnose AFib and atrial flutter, your electrophysiologist performs a physical exam, measures your heart rate using an electrocardiogram (EKG), checks your blood pressure, and asks about your family history. Your doctor may recommend additional laboratory tests, imaging tests, and noninvasive monitoring.
You may notice that your legs, ankles or feet retain water or look swollen if you have AFib. Blood clots. Just as blood clots can reach the brain and cause stroke, they can also reach other parts of the body, though this is rare.
Some people may feel fine when they get up in the morning. But by the end of the day, their lower legs, ankles and feet become swollen. If the swelling is in only one leg, that may suggest a blood clot or infection. When it's related to heart failure, the swelling generally occurs in both legs.
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.
Tachycardia can come from an infection, heart disease, congenital abnormalities , or a number of other causes, and can easily be mistaken for persistent AFib. Anxiety or panic attacks. Anxiety and AFib go hand-in-hand for many people.
Current guidelines support the well-established clinical practice that patients who present with atrial fibrillation (AF) of less than 48 hours duration should be considered for cardioversion, even in the absence of pre-existing anticoagulation.
Some people with AFib have symptoms such as palpitations, shortness of breath, fatigue, dizziness or light-headedness. Other people with AFib have no symptoms at all. AFib can be detected by checking your pulse.
Atrial fibrillation (sometimes called afib or AF) is a type of heart rhythm problem where your heartbeat is not steady. See a GP if you think you may have it.
Fatigue is an overlooked symptom
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.”
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.
A personal survey of patients with atrial fibrillation (AF), one of the most important causes of irregular heartbeats, has found that the majority of triggers for the condition are easily modifiable lifestyle choices, including alcohol, caffeine, exercise and lack of sleep.
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.
Cardiologists play a vital role in managing AFib by assessing your overall heart health, prescribing medications, and offering general heart care.
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.
Catheter ablation is a safe and effective way to treat AFib when medications don't work or cause negative side effects. Catheter ablation usually doesn't require a prolonged hospital stay. Depending on your condition, you may be able to go home the same day as your procedure.
It can be difficult to tell the difference between these changes and signs of an arrhythmia — especially because stress can trigger symptoms of AFib. You're more likely to experience symptoms of stress or anxiety when you are feeling strong emotions, while you may experience AFib at other times.
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.
More common symptoms of AFib
“The key difference is irregularity. Patients often describe AFib as a fluttering or chaotic feeling in their chest rather than a steady, fast pulse.”
Experts have identified heart rate danger zones for AFib patients that should sound an alarm. A resting heart rate consistently over 110-130 beats per minute (bpm) or exercise heart rate exceeding 170 bpm starts entering the high-risk category.
With the right treatment and regular management, most people with persistent atrial fibrillation can live active, healthy lives. The longer persistent Afib goes without treatment, however, the harder it is to manage. It may become permanent or lead to severe complications such as blood clots or stroke.