Atrial fibrillation (AFib): what you need to know
Atrial fibrillation — or AFib — is the most common heart rhythm problem. In this video, Steven Liskov, MD, a cardiac electrophysiologist at Main Line Health, explains the guidelines of what AFib is, who is at risk and how it's treated. Here's a simple overview to help you understand the basics.
Watch this video of Dr. Liskov explaining AFib guidelines
What is AFib?
AFib is a fast, irregular heartbeat that starts in the upper chambers of the heart (the atria).
Normally, the heart beats in a steady rhythm. In AFib, the upper chambers beat chaotically. This can cause:
- A racing or fluttering heartbeat
- An irregular pulse
- Fatigue
- Shortness of breath
- Lightheadedness
Some people feel symptoms. Others don’t feel anything at all.
What causes AFib?
AFib becomes more common as you age. Risk factors include:
- High blood pressure
- Diabetes
- Heart disease
- Obesity
- Smoking
- Sleep apnea
- Heavy alcohol use
Alcohol increases risk. Moderate caffeine (like coffee) is generally safe for most people. Regular exercise helps lower risk. The American Heart Association recommends at least 150 minutes of moderate activity per week.
Why does AFib matter?
The biggest concern is stroke. When the heart's upper chambers don't squeeze properly, blood can pool and form a clot. If a clot travels to the brain, it can cause a stroke. Stroke risk depends on your age and other health conditions. Not everyone with AFib needs the same treatment.
How is AFib diagnosed?
AFib must be confirmed by recording your heart rhythm with:
- An electrocardiogram or ECG (heart tracing)
- A short- or long-term heart monitor
- An FDA-cleared smartwatch (e.g., Apple Watch, Fitbit Sense)*, which should still be confirmed by a doctor
*Many modern smartwatches and wearables can detect irregular heart rhythms that may suggest atrial fibrillation (AFib) and alert you to follow up with your doctor.
How is AFib treated?
Treatment focuses on three main goals:
1. Lower stroke risk
Some patients need a blood thinner (like Eliquis, Xarelto or Pradaxa). Aspirin alone is not enough.
If someone cannot take blood thinners, a device procedure (such as the Watchman) may help reduce stroke risk.
2. Manage risk factors
Controlling blood pressure, diabetes, weight and sleep apnea can reduce AFib episodes. Even modest weight loss can help. Smoking cessation is also vital to helping your heart and overall health.
3. Control symptoms
Options include:
- Medications to steady the heart rhythm
- Cardioversion, a brief procedure that resets the heart rhythm
- Catheter ablation, a minimally invasive procedure that targets the source of AFib (newer ablation technology is faster, safer and more precise than older methods)
AFib is common — and manageable. Not everyone with AFib needs the same treatment, which is why it's important to talk to your doctor about a personalized care plan tailored to your specific needs.
With the right care, healthy habits and regular follow-up, many people with AFib live full, active lives.
Next steps
Make an appointment about AFib with Dr. Liskov by calling 484.476.1000
Having trouble with your heart? Schedule an appointment with a Main Line Health cardiologist.
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