Atrial fibrillation (AFIB) is the most common type of arrhythmia or abnormal heart rhythm. AFIB is caused by an electrical problem in the heart. It affects more than 6 million people in the U.S. and is most commonly diagnosed in older adults.
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Atrial fibrillation, also known as AFib, is an abnormal heart rhythm caused by an electrical problem in the heart. AFib occurs when the top two chambers of the heart (the atria) beat irregularly. This typically causes a fast heartbeat and affects the heart’s ability to pump blood to the rest of the body.
AFib itself is not typically life-threatening, but it is a serious condition that can cause discomfort. If undiagnosed or untreated, AFib can increase the risk of other serious conditions, such as heart failure, blood clots, and stroke.
AFib is the most common type of abnormal heart rhythm, affecting 6 million people in the U.S. and 40 million people around the world. The risk of developing AFib increases with age. Although AFib can occur in people of any age, it is most common in older adults.
There are several categories of AFib, including:
AFib is caused by a problem with the heart’s electrical system, which causes the heart to beat fast and irregularly.
Age is the leading risk factor for atrial fibrillation. Other major risk factors include coronary artery disease, myocardial infarction (heart attack), heart valve problems, congenital heart conditions present at birth, high blood pressure, obstructive sleep apnea, obesity, alcohol use, and thyroid disease.
Although AFib isn't usually life-threatening, it can lead to serious health problems like stroke.
AFib causes the heart to pump blood improperly, which may result in pooling or clotting into a small appendage in the left atrium called the left atrial appendage. If a blood clot moves to an artery in the brain, it can lead to stroke.
In fact, about 15 percent of all strokes occur in people who have AFib.
Untreated AFib can also lead to other serious, even life-threatening, conditions such as:
You may not be able to prevent AFib, especially if you have a family history or another type of heart disease. However, a healthy lifestyle can help prevent or lessen the risk of AFib and other heart conditions.
To reduce your risk of AFib:
AFib symptoms can vary. Some people have no symptoms or very vague symptoms such as fatigue. Others can be very symptomatic with chest pain, palpitations, shortness of breath, or lightheadedness.
AFib can cause a fast heartbeat, sometimes as high as 170 beats per minute. The most common symptom is palpitations, which some describe as a fluttering sensation in the chest.
Common AFib signs and symptoms include:
If you have AFib symptoms, contact your primary care provider or cardiologist right away. You should contact a provider when you are experiencing:
Sometimes, providers may suspect AFib after listening to your heart sounds or feeling your pulse. However, the only way to truly diagnose atrial fibrillation is by obtaining an electrocardiogram (ECG/EKG). This test records the electrical activity of your heart, shows abnormal rhythms, and can sometimes detect heart muscle damage.
When you arrive for your first appointment, you'll meet with a physician, nurse practitioner, or physician assistant. He or she will ask about your medical history and AFib symptoms.
We'll give you a:
Together, you will design and agree on a care plan which may include additional testing. Tests to diagnose AFib and help to formulate a treatment plan may include:
AFib is not usually life-threatening, but getting early treatment can help reduce the risk of related problems. You should work closely with your doctor to manage your AFib.
Make sure you go to all your medical appointments, follow your doctor’s instructions, take your medications (if any) as directed, and tell your doctor about any changes in your AFib symptoms.
Your overall outlook can be dependent on your lifestyle choices. Obesity, untreated sleep apnea, and alcohol use are significant contributing risk factors for AFib.
Each case of AFib is unique and requires customized treatment. Your treatment will depend on your symptoms, age, how long you've had AFib, and heart function.
The goals of AFib treatment are to:
At the UPMC Heart and Vascular Institute, our experts will find the right treatment for you.
One of your provider’s first priorities will be to determine your risk of blood clots and stroke. Your provider may prescribe:
Blood thinners that prevent clots from forming and help reduce risk of stroke, such as:
Medications to control heart rate and rhythm
Your provider will recommend two potential treatment options:
Drugs can be used to slow the heart rate or to help stay in normal rhythm.
Rate control drugs to slow the heart rate include:
Rhythm control drugs to maintain a regular heart rhythm include:
Based on your unique case, our AFib experts can decide if medication is right for you.
Cardioversion is a noninvasive treatment that restores your heart's normal rhythm with a shock or drug.
Electrical shock cardioversion
Chemical cardioversion uses medicine to achieve the same effect.
UPMC's Heart and Vascular Institute offers both types of cardioversion treatment for AFib and other heart arrhythmias.
Catheter ablation or pulmonary vein isolation is a minimally invasive procedure that can help the heart achieve and maintain a normal rhythm. It removes or destroys (ablates) a small amount of tissue that is causing abnormal heart rhythm.
At UPMC, our experts have authored and published book chapters and research on ablation techniques and perform many procedures each year.
During your ablation, your doctor will:
When the catheter is in the right place, your doctor will burn a small amount of tissue using:
Your UPMC doctor may suggest implanting a device to help control how your heart beats:
An electrophysiologist — a cardiologist who specializes in treating heart rhythm problems — implants the device and connects its electrodes to the heart during a minimally invasive procedure.
If you have severe AFIB that hasn’t responded to other treatments, the experts at UPMC's Center for Atrial Fibrillation may suggest surgery.
Surgery may give you better long-term results when:
This will depend on the type of procedure you are having.
One of the most common surgical procedures for AFIB is a MAZE procedure. During MAZE, your surgeon will make tiny cuts on the outside of your heart to create a maze-like pattern of scars in your atria. These scars block the abnormal electrical signals.
There are two types of MAZE procedures for AFIB:
Surgeons at UPMC's Center for Atrial Fibrillation are experts in the MAZE procedure. Our research and experience have helped advance this treatment for AFib.
Benefits of MAZE procedures for AFib include:
Another type of cardiac surgery for AFIB is called isolated left atrial appendage ligation.
Surgeons may suggest this type of surgery if you are a good candidate for MAZE surgery, as they are typically performed together. Using a clip to clamp off the left atrial appendage also helps to reduce the abnormal signals that cause atrial fibrillation. The clip may also reduce the risk of stroke.
Hybrid ablation is a minimally invasive treatment for AFIB. It combines both the surgical MAZE procedure and left atrial appendage clip with catheter-based pulmonary vein isolation. The procedure targets small amounts of tissue on the inside and outside of the heart, creating scar tissue that blocks abnormal electrical signals.
Your hybrid ablation will be performed by an electrophysiologist and a cardiac surgeon. The procedures are done in stages.
Typically, the MAZE and left atrial appendage clip procedure are performed first by the cardiac surgeon. Then, approximately eight weeks later, pulmonary vein isolation is performed by the electrophysiologist.
You will be asleep during these procedures with general anesthesia.
Your doctors will:
Many people with AFIB take blood thinners to lower their stroke risk, but they aren't safe for everyone. Left atrial appendage closure (LAAC) using a Watchman or Amulet device may lower the risk of stroke in some people with AFIB who are unable to take blood-thinning drugs.
These devices are implanted in the left atrial appendage of the heart. This is the part of the heart where blood clots may form that cause stroke in people with AFib.
Some people who might benefit from LAAC include those who:
During a LAAC procedure, your doctor will:
In most cases, LAAC takes about one hour or less to perform. Over time, scar tissue forms around the device and closes off the left atrial appendage permanently.
Our experts can recommend the best AFIB treatment for you and develop a plan to help you manage your risk for stroke and other complications. With early diagnosis and ongoing care, AFIB can be effectively treated or managed.
The UPMC Heart and Vascular Institute provides the latest AFIB research and treatment options.
Our experts are leaders in AFIB techniques and teach patients and families about the condition.
The UPMC Cardiac Electrophysiology Program offers the full range of treatments for AFIB and other heart arrhythmias.
Last reviewed by Erica Byers, CRNP on 2024-10-01.
