Atrial Fibrillation Patient Guide
Understanding and managing your AFib journey from diagnosis to daily life
Atrial fibrillation (AFib) is an irregular heartbeat that increases stroke risk. Management involves three approaches: rate control (slowing heart rate with beta-blockers or calcium channel blockers), rhythm control (restoring normal rhythm with medications or procedures like cardioversion or ablation), and stroke prevention (blood thinners like warfarin or DOACs). Monitor pulse regularly, limit alcohol, manage stress, and take medications as prescribed.
Quick Answer
Atrial fibrillation (AFib) is the most common heart rhythm disorder. While it's not immediately life-threatening, it requires proper management to prevent stroke and other complications. With the right treatment plan, most people with AFib live full, active lives.
Understanding Atrial Fibrillation
What is AFib?
In atrial fibrillation, the upper chambers of your heart (atria) beat chaotically and irregularly, instead of beating in a coordinated way. This can cause:
- An irregular pulse
- Heart rates that are too fast (sometimes over 150 beats/minute)
- Blood not pumping efficiently
Types of AFib
| Type | Description | Duration |
|---|---|---|
| Paroxysmal | Comes and goes | Stops within 7 days (usually <24 hours) |
| Persistent | Continues until treated | Lasts >7 days |
| Long-standing Persistent | Continuous | Lasts >1 year |
| Permanent | Continuous | Accepted as permanent |
Common Symptoms
Some people have no symptoms. Others may experience:
- Palpitations (feeling like heart is racing or fluttering)
- Fatigue or weakness
- Shortness of breath
- Dizziness or lightheadedness
- Chest discomfort
- Reduced exercise tolerance
The Stroke Connection
AFib increases stroke risk 5-fold because blood can pool in the heart and form clots. These clots can travel to the brain.
Your Stroke Risk Score (CHA2DS2-VASc)
| Factor | Points |
|---|---|
| Congestive heart failure | 1 |
| Hypertension | 1 |
| Age ≥75 | 2 |
| Age 65-74 | 1 |
| Diabetes | 1 |
| Stroke/TIA history | 2 |
| Vascular disease | 1 |
| Sex (female) | 1 |
Score 0: Usually no blood thinner needed Score 1: Consider blood thinner Score ≥2: Blood thinner recommended
Treatment Approaches
1. Rate Control
Slowing the heart rate to a normal range (usually 60-100 bpm at rest).
Medications:
- Beta-blockers (metoprolol, atenolol)
- Calcium channel blockers (diltiazem, verapamil)
- Digoxin (often combined with above)
Goals:
- Resting heart rate <110 bpm (sometimes <80)
- Relief of symptoms
- Better quality of life
2. Rhythm Control
Trying to restore and maintain normal heart rhythm.
Medications (Antiarrhythmics):
- Flecainide
- Propafenone
- Amiodarone
- Sotalol
- Dofetilide
Procedures:
- Electrical Cardioversion: Controlled electric shock to reset rhythm
- Catheter Ablation: Procedure to scar tissue causing irregular signals
- Pacemaker: If rhythm control causes slow heart rate
3. Anticoagulation (Stroke Prevention)
Direct Oral Anticoagulants (DOACs):
- Apixaban (Eliquis)
- Rivaroxaban (Xarelto)
- Dabigatran (Pradaxa)
- Edoxaban (Savaysa)
Warfarin (Coumadin):
- Requires regular INR blood tests
- Affected by foods high in vitamin K
- Many drug interactions
Choosing Your Path
Your doctor will consider:
- How long you've had AFib
- Your symptoms
- Your stroke risk
- Your bleeding risk
- Other health conditions
- Your preferences
Self-Monitoring
Check Your Pulse Regularly
- Place two fingers on your wrist (thumb side) or neck
- Count beats for 30 seconds
- Multiply by 2 for beats per minute
- Note if rhythm is regular or irregular
Normal resting rate: 60-100 bpm Report: Consistently >100 bpm at rest or very irregular
Mobile ECG Devices
Consider using:
- Smartwatch ECG features (Apple Watch, etc.)
- Handheld ECG devices (KardiaMobile)
- These can help detect AFib episodes
Lifestyle Modifications
Triggers to Avoid
- Alcohol: Especially binge drinking (>3-4 drinks)
- Caffeine: In excess (varies by person)
- Stress: Practice relaxation techniques
- Sleep deprivation: Aim for 7-8 hours
- Stimulants: Some cold medicines, energy drinks
Heart-Healthy Habits
- Exercise regularly - 150 minutes moderate activity weekly
- Maintain healthy weight - Obesity worsens AFib
- Control blood pressure - Hypertension is a major trigger
- Manage sleep apnea - If diagnosed, use CPAP
- Quit smoking - Smoking increases AFib risk
- Limit alcohol - Some people need to avoid completely
When to Seek Emergency Care
Call 911 If:
- Chest pain or pressure
- Signs of stroke (FAST):
- Face drooping
- Arm weakness
- Speech difficulty
- Time to call 911
- Fainting
- Severe shortness of breath
Contact Your Doctor If:
- New or worsening palpitations
- Heart rate consistently >100 bpm at rest
- Increased fatigue
- Side effects from medications
- Any bleeding concerns (if on blood thinners)
Living with Blood Thinners
Bleeding Precautions
- Use soft toothbrushes
- Electric razors instead of blades
- Be cautious with sharp objects
- Wear medical alert bracelet
- Inform all doctors you're on anticoagulants
When to Seek Help for Bleeding
- Unusual bruising
- Bleeding that won't stop
- Blood in urine or stool
- Severe headache
- Vomiting blood
Key Takeaways
- AFib is manageable - Most people live normal lives
- Stroke prevention is critical - Take blood thinners as prescribed
- Know your treatment goals - Rate vs. rhythm control
- Monitor your pulse - Know your baseline
- Avoid triggers - Alcohol, stress, lack of sleep
- Stay active - Exercise is beneficial
- Know stroke signs - FAST and act immediately
Atrial fibrillation is a journey, not a destination. Work closely with your healthcare team, take medications as prescribed, and make heart-healthy choices. You have the power to manage your AFib effectively.
Disclaimer: This content is for informational purposes only and does not constitute medical advice. Consult your healthcare provider for personalized guidance.