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Atrial fibrillation is an irregular heartbeat, or arrhythmia. Atrial fibrillation, also known as AFib or AF, can lead to blood clots, , heart failure and other heart-related complications. AFib is the most common type of irregular heart rhythm, affecting more than 10 million people in the U.S.

During AFib, the heart’s upper chambers beat out of sync with the lower chambers. This can affect how blood moves through the heart and body.

Some people describe AFib as:

• A fluttering feeling in the chest
• A racing or pounding heartbeat
• Skipped beats
• Feeling weak, dizzy or lightheaded

Like many heart conditions, AFib is a progressive disease. It has four stages. Many people live with a diagnosis of AFib for years with the help of treatment, monitoring and healthy lifestyle habits.

Explore More:

• What is AFib?
• Stages of AFib

AFib occurs when abnormal electrical signals cause the heart’s upper chambers (atria) to beat irregularly. As a result, blood can pool in the atria and form clots, increasing the risk of stroke. Sometimes the cause of AFib is unclear. Other times, it may be linked to conditions that affect the heart or circulatory system, including:

• Long-term, uncontrolled high blood pressure
• Underlying heart disease, such as coronary artery disease or heart valve problems
• Complications after heart surgeries
• Chronic health conditions, such as Type 2 diabetes or thyroid disease
• Alcohol use
• Smoking
• Sleep apnea
• Obesity
• Family history

No. Atrial flutter is another type of abnormal heart rhythm. It can have similar symptoms, causes and risks as AFib. It can happen in those who also have AFib, but the rhythm pattern is different. Both conditions can increase the risk of stroke and may require treatment, including medication and ablation.

Learn more:

• What is atrial flutter
• Treatment of atrial flutter

Sometimes, the cause of AFib is unknown. Other times, it is the result of damage to the heart’s electrical system from other conditions, including:

• Long-term, uncontrolled high blood pressure
• Coronary artery disease
• Complications after heart surgeries

Some people notice symptoms right away, while others learn they have AFib during a routine exam or while being treated for another condition.

Common symptoms may include:

• Fluttering or pounding heartbeat
• Fast or irregular heartbeat
• Fatigue
• Feeling weak, dizzy or lightheaded
• Shortness of breath
• Chest pain or pressure – this can be a medical emergency. You may be having a heart attack. Call 911 right away if you have one of these symptoms.

Understand more:

• AFib Symptom Tracker (PDF)

AFib becomes more common with age, but it can affect adults of many ages and backgrounds. Risk factors may include:

• Long-term, uncontrolled high blood pressure
• Underlying heart disease, such as coronary artery disease or heart valve problems
• Complications after heart surgeries
• Chronic health conditions, such as Type 2 diabetes or thyroid disease
• Alcohol use
• Smoking
• Sleep apnea
• Obesity
• Family history

Your healthcare professional may diagnose AFib through:

• A physical exam
• Medical history
• Electrocardiogram (EKG)
• Heart rhythm data collected from a wearable device
• Additional heart rhythm testing

Sometimes AFib is discovered during treatment for another condition.

Explore more:

• What is an EKG?
• Electrophysiology studies explained

Treatment depends on your symptoms, stroke risk and overall health goals. Many people use a combination of medications, procedures and lifestyle changes.

Treatment goals may include helping the heart beat more regularly, slowing a fast heart rate, lowering stroke risk and improving quality of life.

Common treatments may include:

• Anticoagulants, sometimes called blood thinners
• Heart rhythm medications
• Heart rate medications
• Cardioversion
• Catheter ablation
• Pacemakers or other devices

For most people, medications might be an appropriate treatment for AFib. But sometimes other treatments may be needed. These include nonsurgical and surgical methods. Talk to your healthcare professional about which option is best for you.

Nonsurgical methods include:

• Electrical cardioversion – If your heart has an irregular (uneven) beat or is beating too fast, cardioversion is a procedure that can restore a regular rhythm.
• Radiofrequency ablation or catheter ablation - Ablation is another procedure that can stop the signals that make the heart beat abnormally.

Even with treatment, AFib may come back. You may need medications for a long time to keep your heart’s rhythm and rate in the best range and to reduce stroke risk.

Some people with AFib need surgery to help their heart beat normally. Surgery might include a device placed in the body to help control heart rhythm and speed. Maze heart surgery creates scar tissue to help stop AFib.

Surgical methods include:

Pacemaker

A pacemaker is a small electrical device that helps keep your heart from beating too slowly. It may be recommended for people with certain heart rhythm problems, including some people with AFib who have slow heart rates or alternating fast and slow heart rhythms.

Traditional pacemakers are placed under the skin near the collarbone during a procedure. Thin wires (called leads) connect the device to the heart and deliver electrical signals that help maintain an appropriate heart rate. Newer leadless pacemakers are placed directly inside the heart and do not require wires or a device under the skin.

While a pacemaker does not treat AFib, it can help manage slow heart rhythms and may be used as part of an overall treatment plan recommended by your healthcare team. 

Learn More:

• Learn more about living with your pacemaker.
• Read about devices that may interfere with your pacemaker.
• What is a pacemaker? (PDF)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)(link opens in new window)

Left atrial appendage occlusion

Left atrial appendage occlusion (LAAO), or left atrial appendage closure, is a procedure that blocks or closes the opening of the left atrial appendage (LAA). The LAA is a pouch in the left atrium that can pool with blood if someone has AFib. This allows blood clots to form. If these blood clots enter the bloodstream, it increases the risk of stroke. Closing the LAA reduces the risk of stroke. It can also allow the person to stop taking anticoagulants (sometimes called blood thinners) to prevent clots. The heart can continue to work normally with the LAA closed.

Open-heart maze procedure

Maze heart surgery is a complex procedure. Traditionally, a surgeon would make small cuts in the top part of the heart. Stitching those cuts together forms scar tissue. The scar tissue blocks the signals that cause AFib. This can help restore a normal heartbeat.

Today, the procedure is more commonly performed using cryoablation or radiofrequency ablation. These techniques create targeted areas of scar tissue without the need for surgical cuts. In some cases, both surgical and catheter-based approaches may be used to help restore a normal heart rhythm.

Learn more:

• AFib treatment options
• AFib medications
• Ablation procedures
• Living with a pacemaker
• DOAC guide

There are medications to treat the risk of AFib and medications to address AFib.

Medications to treat the risks of AFib:

People with AFib are often prescribed medications to prevent and treat blood clots that can lead to a stroke. Other medications to control your heart rate and rhythm may also be prescribed.

The heart rhythm can be harder to control. The longer you have untreated atrial fibrillation, the harder it is to get back in and stay at a normal rhythm.

Medication options may include:

• Anticoagulants, sometimes called blood thinners
• Heart rate controllers
• Heart rhythm controllers

We encourage you to talk with your healthcare professional to keep up with the newest AFib medication options.

Your healthcare professional may use an assessment scale called the CHA2DS2–VASc risk to help decide if you need a blood thinner. The factors of the scale are:

• Congestive heart failure
• Hypertension (high blood pressure)
• Age (75 or older)
• Diabetes
• Stroke (prior stroke)
• Vascular disease (prior heart attack, peripheral artery disease or aortic plaque)
• Age (65-74)
• Sex (female)

The more factors you have may result in increased use of medications.

Preventing clots with medication (antiplatelets and anticoagulants)

Healthcare professionals prescribe medications to prevent blood clots or treat an existing blood clot. Some examples include:

• Direct-acting oral anticoagulants (DOACs) such as:
• Dabigatran
• Rivaroxaban
• Edoxaban
• Apixaban
• Heparin
• Warfarin
• Plavix and other antiplatelets

Call your healthcare professional right away if you have any side effects from taking these medications. Always talk to your healthcare professional before making any changes to your medications. Even small changes can cause problems.

Always tell your healthcare professionals, including dentist and pharmacist, that you take these medications. This is especially important before you take a new medication or have a procedure that can cause bleeding.

Take extra care with contact sports or any situation that might risk trauma.

Here are some things to watch for or report to your healthcare professional:

• Have an accident of any kind
• Often find bruises or blood blisters
• Feel sick, weak, faint or dizzy
• Think you are pregnant
• Notice red, dark brown or black urine or stools
• Bleed more during your menstrual cycle
• Notice bleeding gums
• Have a headache or stomachache that won’t go away

Medications to treat atrial fibrillation

Some medications used to treat AFib are heart rate-controlling medications that slow down the electrical signals from the upper to the lower chambers of the heart. These include:

• Beta blockers
• Calcium channel blockers
• Digoxin

Once your heart rate is controlled, another priority might be treating the abnormal heart rhythm with medications. Your healthcare professional will most likely want to monitor your progress closely.

AFib can allow blood to pool in the heart, which may lead to blood clots. If a clot travels to the brain, it can cause a stroke. The good news is that treatment and healthy lifestyle choices can help lower stroke risk.

Many people lower their risk by following Life’s Essential 8™. These are health behaviors and factors for improving heart health. These actions help lower the risk of heart disease and keep your circulatory system in the best condition:

• Get regular physical activity
• Eat a heart-healthy diet low in sodium (salt), saturated fats, trans fats, added sugars and cholesterol
• Manage high blood pressure
• Manage blood sugar
• Avoid excessive amounts of alcohol and caffeine
• Don’t smoke
• Control cholesterol
• Maintain a healthy weight
• Get healthy sleep

Access our patient information sheets on how to live a heart-healthy lifestyle.

Many people with AFib continue to work, exercise, travel and enjoy daily activities. Finding the right treatment plan may take time, and support from your health care team can help. Managing your AFib may feel overwhelming, but you don’t have to do it alone. You, your caregiver and your healthcare professional can work together to make choices about your treatment. This is called shared decision-making. This includes the best way to manage your AFib and support your health goals,

Managing AFib often includes:

• Monitoring symptoms
• Taking medications consistently
• Attending regular medical visits
• Building heart-healthy habits
• Understanding stroke warning signs

Your healthcare team may include:

• Primary care professionals
• Cardiologists
• Electrophysiologists
• Emergency room doctors
• Critical care doctors
• Hospitalists
• Cardiothoracic surgeons
• Pharmacists

You can ask questions, share concerns and work together to find approaches that fit your life and health goals.

You may encounter these terms when discussing your symptoms and treatment with healthcare professionals.

• Atrial fibrillation (AFib) is a quivering or irregular heartbeat, or arrhythmia, that can lead to blood clots in the heart and increase the risk of having a stroke or heart failure.
• Sinus rhythm is the heart’s natural rhythm. The sinus node in the heart creates an electrical impulse that causes the heart to beat.
• Bradycardia is a slower-than-normal heart rate.
• Tachycardia is a faster-than-normal heart rate.
• Persistent AFib is a type of AFib in which an abnormal heart rhythm lasts longer than seven days.
• Paroxysmal AFib is a type of AFib in which an abnormal heart rhythm occurs and stops suddenly within seven days.
• Atrial flutter is a type of abnormal heart rhythm that is treated similarly but separately from AFib.
• Palpitations are a feeling that your heart is racing or pounding. Palpitations can be caused by diet, stress and health conditions. Healthcare professionals can help determine the cause.

• Living With AFib Guide (PDF) | Cómo vivir con FA (PDF)
• For more AFib resources, including videos, go to heart.org/AFibTools