Atrial Fibrillation (AF) Quiz
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Irregular palpitations
Heart palpitations
Irregular heartbeat
Abnormal heart rhythms
My heart is pounding
I have heart arrhythmia
Irregular heart beat
Not seeing your symptoms? No worries!
What is Atrial Fibrillation (AF)?
Atrial fibrillation is a heart condition causing an irregular and often abnormally fast heart rate, which can result in blood clots in the heart. It increases the risk of stroke, heart failure, and other heart-related complications. Common causes include heart valve diseases and heart failure.
Typical Symptoms of Atrial Fibrillation (AF)
- Irregular heartbeat
- Pounding, rapid or fluttering heartbeat related to breathing
- Fatigue or low energy that is worse in the morning
- Pounding, rapid or fluttering heartbeat during exercise
- Fast heartbeat (more than 100 beats a minute)
- Irregular heart pounding
- Heart pounding
- Difficulty concentrating
Diagnostic Questions for Atrial Fibrillation (AF)
Your doctor may ask these questions to check for this disease:
- Have you been experiencing an irregular heartbeat?
- Are the palpitations related to your breathing?
- Do you experience fatigue or low energy that is worse in the morning?
- Do you get heart palpitations when you exercise?
- Have you been experiencing a fast heartbeat (more than 100 beats a minute)?
Treatment of Atrial Fibrillation (AF)
Medications, such as beta blockers, are typically prescribed to control and restore a normal heart rhythm. The choice of medication depends on the cause of the atrial fibrillation. Medications to reduce stroke risk may also be prescribed.
Reviewed By:
Osler Jay Justo Guzon, MD (Cardiology)
Dr. Guzon graduated from the University of Missouri-Kansas City School of Medicine with a BLA and MD. He then completed his Internal Medicine Residency at St. Louis University before a fellowship in Cardiovascular Diseases at the University of Missouri-Columbia. He has since working as an invasive cardiologist with a particular interest in preventative medicine and cardiometabolic disease. Over the past several years, Dr. Guzon has served on the speaker bureaus of AstraZeneca, Lilly, Boehringer-Ingelheim, and Aralez.
Tatsuya Shiraishi, MD (Cardiology)
Dr. Shiraishi graduated from the Kyoto University School of Medicine. He worked as a cardiologist at Edogawa Hospital, and after joining Ubie, he became the Director of East Nihonbashi Internal Medicine Clinic.
Content updated on Apr 4, 2024
Following the Medical Content Editorial Policy
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Symptoms Related to Atrial Fibrillation (AF)
Diseases Related to Atrial Fibrillation (AF)
FAQs
Q.
Afib on Flecainide? Why Your Heart Is Misfiring & Proven Medical Steps
A.
There are several factors to consider. AFib can persist or worsen while taking flecainide due to underdosing, disease progression, ongoing triggers such as alcohol, dehydration, thyroid imbalance or sleep apnea, and rare proarrhythmic effects, so correct patient selection is critical; see details below. Proven medical steps include adjusting or switching drugs and pairing with a rate-control agent, ECG and longer monitoring, an echocardiogram to reassess safety, considering catheter ablation if medications fail, stroke prevention with anticoagulants, and targeted lifestyle changes; seek urgent care for chest pain, severe shortness of breath, fainting, stroke signs, or very rapid rates, and review the complete guidance below.
References:
* Kotecha D, Waddingham C, Lopes P, et al. Antiarrhythmic Drugs for Atrial Fibrillation: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 May 12;75(18):2330-2349. doi: 10.1016/j.jacc.2020.03.048. PMID: 32376288.
* Pardo E, Del Olmo B, de Andrés B, et al. Pharmacological treatment of atrial fibrillation: a narrative review. Front Cardiovasc Med. 2023 Jul 11;10:1229712. doi: 10.3389/fcvm.2023.1229712. PMID: 37494396.
* Khan IA. Current Role of Flecainide in the Management of Atrial Fibrillation. Curr Cardiol Rev. 2018;14(1):27-31. doi: 10.2174/1573403X14666171206144807. PMID: 29550742.
* Singh BN, Nattel S, Khan IA, et al. Mechanisms of action of antiarrhythmic drugs and their clinical implications. J Cardiovasc Transl Res. 2020 Aug;13(4):453-472. doi: 10.1007/s12265-020-10022-7. PMID: 32587522.
* Katritsis DG, Camm AJ. Flecainide: The Antiarrhythmic for All Seasons. J Am Coll Cardiol. 2019 Mar 5;73(8):964-972. doi: 10.1016/j.jacc.2018.11.055. PMID: 30819777.
Q.
Heart Fluttering? Why Your Heart Is Beating Irregularly & Medically Approved AFib Steps
A.
Heart fluttering or an irregular, racing, or skipping heartbeat can be harmless, but it may signal atrial fibrillation, which raises stroke risk; medically approved steps include assessing stroke risk, using anticoagulants when indicated, controlling heart rate, and in select cases restoring normal rhythm plus lifestyle changes. There are several factors to consider. See details below on red flag symptoms that need urgent care, common triggers and risks, how AFib is diagnosed, and which next steps may be right for you.
References:
* Nattel S. Mechanisms of atrial fibrillation: a current perspective. Eur Heart J. 2020 Sep 7;41(34):3287-3296. doi: 10.1093/eurheartj/ehaa440. PMID: 32777977.
* Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Dement J, Eaton CB, Hess JJ, Jencks KW, Khan SS, Lackland DT, Seeman T, Shulman EP, Stokes A, VanWagner LB, Wang Y, Yano Y, Hanley A; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2023 Oct 3;148(14):e185-e362. doi: 10.1161/CIR.0000000000001169. Epub 2023 Sep 25. PMID: 37703351.
* Chung EH, Lim SH, Cha TJ, Hong YJ, Kim H. Pharmacological and Nonpharmacological Therapies for Atrial Fibrillation. J Clin Med. 2023 Jan 24;12(3):931. doi: 10.3390/jcm12030931. PMID: 36729377; PMCID: PMC9917387.
* Staerk L, Wang B, Hylek EM, Nielsen PB, Lip GYL, Overvad TF, Køber L, Torp-Pedersen C, Gislason GH. Risk Factors for Atrial Fibrillation: Current Understanding and Future Directions. J Am Heart Assoc. 2022 Jan 18;11(2):e023724. doi: 10.1161/JAHA.121.023724. Epub 2022 Jan 18. PMID: 35057041; PMCID: PMC8793077.
* Reiffel JA, Kowey PR. Atrial Fibrillation: An Overview. Am J Med. 2020 Sep;133(9):1004-1011.e1. doi: 10.1016/j.amjmed.2020.03.016. Epub 2020 Jul 2. PMID: 32623055.
Q.
Heart Flutter? Why Your Mitral Valve is Leaking & Medically Vetted Steps
A.
Heart flutter can be caused by a leaking mitral valve, which ranges from mild and monitor-only to serious, and may trigger atrial fibrillation that increases stroke risk; timely evaluation, symptom tracking, blood pressure control, imaging follow up, and in some cases repair or AF treatment are key. There are several factors to consider. For specific causes, diagnostic tests, follow up timelines, treatment choices, emergency red flags, and lifestyle steps that could change your next move, see the complete guidance below.
References:
* Nishimura RA, Vahanian A, Eleid MF, Mack MJ. Primary Mitral Regurgitation. N Engl J Med. 2018 Mar 22;378(12):1134-1143. doi: 10.1056/NEJMcp1615802. PMID: 29562149.
* Sannino A, Smith RL, Feldman T. Functional Mitral Regurgitation. JACC Cardiovasc Imaging. 2019 Jul;12(7 Pt 2):1359-1375. doi: 10.1016/j.jcmg.2018.06.027. PMID: 31272782.
* Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP 3rd, Gentile M, Jneid H, Krieger EV, Mack M, McLeod E, O'Gara PT, Palmer C, Quan H, Yaffe MB. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021 Feb 2;77(8):e1-e160. doi: 10.1016/j.jacc.2020.11.018. Epub 2020 Dec 17. PMID: 33334521.
* Enriquez-Sarano M, Tribouilloy C, Borg UL. Mitral Regurgitation. J Am Coll Cardiol. 2019 Jul 23;74(3):360-372. doi: 10.1016/j.jacc.2019.05.041. PMID: 31320193.
* Kanda S, Kaneko T, Takagi K, Minami T, Saito K, Miyairi S, Oshima H, Seki A, Tanaka H, Okamura H, Fukuda T, Hoshino K, Ito H, Koyama S, Ota S. Atrial Fibrillation and Its Relationship With Mitral Regurgitation. J Am Heart Assoc. 2023 Jul 18;12(14):e029340. doi: 10.1161/JAHA.122.029340. Epub 2023 Jul 11. PMID: 37427181.
Q.
Heart Racing? Why A-Fib Happens and Medically Approved Next Steps
A.
Atrial fibrillation is a common cause of a racing or fluttering heart due to disorganized signals in the atria, which raises stroke risk and, if rapid for long periods, can lead to heart failure. There are several factors to consider, including high blood pressure, thyroid disease, sleep apnea, alcohol use, age, diabetes, obesity, and underlying heart problems. Medically approved next steps include prompt evaluation with an ECG, stroke prevention with blood thinners when indicated, heart rate control, and sometimes rhythm restoration with medications, cardioversion, or catheter ablation, plus targeted lifestyle changes; see the complete guidance below for how doctors choose among options and the urgent warning signs that require emergency care.
References:
* Dobrev D, Nattel S. Mechanisms of Atrial Fibrillation. Annu Rev Physiol. 2023 Feb 10;85:313-340. doi: 10.1146/annurev-physiol-032221-011211. Epub 2022 Nov 3. PMID: 36327339.
* Joglar JA, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2023 Sep 26;82(13):e1-e209. doi: 10.1016/j.jacc.2023.04.017. Epub 2023 Aug 1. PMID: 37620160.
* Li H, Zhang J, Sun F, Zheng R. Risk factors for atrial fibrillation: Update on the current knowledge and clinical implications. Front Cardiovasc Med. 2022 Dec 12;9:1068897. doi: 10.3389/fcvm.2022.1068897. PMID: 36578709; PMCID: PMC9789325.
* Kirchhof P, Camm AJ, Goette A, et al. Advances in the treatment of atrial fibrillation. Nat Rev Cardiol. 2021 Dec;18(12):831-848. doi: 10.1038/s41569-021-00569-0. Epub 2021 Jul 26. PMID: 34312529.
* Nattel S, Dobrev D, Gabora E, et al. Atrial Fibrillation: A Global Perspective on Mechanisms and Management. Cardiovasc Res. 2020 Jun 1;116(7):1243-1262. doi: 10.1093/cvr/cvaa017. PMID: 32060592.
Q.
Heart Out of Sync? Why Your Heart Needs a Pacemaker & Medically Approved Next Steps
A.
A pacemaker is used when your heart beats too slowly or unpredictably, causing symptoms like dizziness, fainting, fatigue, or shortness of breath, and it restores a safe, steady rhythm to protect blood flow and improve energy. There are several factors to consider that can change your next steps. See below for the causes that warrant a pacemaker, how doctors confirm the need, what the procedure and recovery involve, the risks and daily precautions, and exactly when to seek urgent care versus schedule an appointment.
References:
* Tiyyagura R, Singh SK, El-Sherif A. Permanent Pacemaker Implantation: An Update. Clin Exp Hypertens. 2018;40(6):525-530. doi: 10.1080/10641963.2017.1407238. Epub 2018 Jan 18. PMID: 30016259.
* Wong KK, Tan JFR. Bradycardia: A Review of the Current Evidence and Management. J Clin Med. 2021 Jul 21;10(14):3211. doi: 10.3390/jcm10143211. PMID: 34299839; PMCID: PMC8304918.
* Kusumoto FM, Schoenfeld MH, Wilkoff BL, et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2018 Aug 21;138(10):e128-e228. doi: 10.1161/CIR.0000000000000628. Epub 2018 Aug 20. PMID: 30132644.
* Park YH, Park JH. Long-term follow-up of cardiac implantable electronic devices (CIEDs): a review. J Arrhythm. 2019 Jun;35(3):363-368. doi: 10.1002/joa3.12187. Epub 2019 Apr 12. PMID: 31338029; PMCID: PMC6630453.
* Chen T, Luo C, Deng Y. Recent advances in cardiac pacing technologies. J Cardiovasc Transl Res. 2022 Oct;15(5):849-866. doi: 10.1007/s12265-021-10200-y. Epub 2022 Jan 27. PMID: 35106606; PMCID: PMC8793288.
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Lau DH, Linz D, Sanders P. New Findings in Atrial Fibrillation Mechanisms. Card Electrophysiol Clin. 2019 Dec;11(4):563-571. doi: 10.1016/j.ccep.2019.08.007. PMID: 31706465.
https://www.cardiacep.theclinics.com/article/S1877-9182(19)30108-X/fulltextBosch NA, Cimini J, Walkey AJ. Atrial Fibrillation in the ICU. Chest. 2018 Dec;154(6):1424-1434. doi: 10.1016/j.chest.2018.03.040. Epub 2018 Apr 6. PMID: 29627355; PMCID: PMC6335260.
https://journal.chestnet.org/article/S0012-3692(18)30545-2/fulltextZimetbaum P. Atrial Fibrillation. Ann Intern Med. 2017 Mar 7;166(5):ITC33-ITC48. doi: 10.7326/AITC201703070. Erratum in: Ann Intern Med. 2017 Jun 20;166(12 ):920. PMID: 28265666.
https://www.acpjournals.org/doi/10.7326/AITC201703070Reddy V, Taha W, Kundumadam S, Khan M. Atrial fibrillation and hyperthyroidism: A literature review. Indian Heart J. 2017 Jul-Aug;69(4):545-550. doi: 10.1016/j.ihj.2017.07.004. Epub 2017 Jul 5. PMID: 28822529; PMCID: PMC5560908.
https://www.sciencedirect.com/science/article/pii/S0019483217302626?via%3DihubKallistratos MS, Poulimenos LE, Manolis AJ. Atrial fibrillation and arterial hypertension. Pharmacol Res. 2018 Feb;128:322-326. doi: 10.1016/j.phrs.2017.10.007. Epub 2017 Oct 18. PMID: 29055746.
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