Atrial fibrillation

The main symptoms of atrial fibrillation are:

• an irregular heartbeat, where your pulse is not steady
• suddenly feeling like your heart is pounding, racing, fluttering, skipping or missing a beat (heart palpitations) – this may last for a few seconds up to a few minutes
• a heartbeat faster than 100 beats per minute
• feeling very tired
• finding it harder to exercise
• chest pain or tightness
• feeling short of breath, lightheaded, dizzy or like you might faint

Sometimes there are no symptoms, and atrial fibrillation is found as part of a routine check-up or when you're having tests for something else.

If you do get symptoms, they may start and stop on their own (paroxysmal atrial fibrillation) or stop after treatment (persistent atrial fibrillation).

Over time, you may always have symptoms (permanent atrial fibrillation).

• you think you may have symptoms of atrial fibrillation
• you have heart palpitations that keep happening or are getting worse
• you have been diagnosed with atrial fibrillation and treatment is not helping your symptoms

If a GP thinks you could have atrial fibrillation, they will refer you to a heart specialist (cardiologist).

At your appointment, they will ask about your symptoms and check your heart rate.

You will also have tests to see if anything else could be causing your symptoms and to check your heart rhythm. Tests may include:

• an electrocardiogram (ECG)
• an echocardiogram (echo)
• a chest X-ray
• blood tests

If you have been diagnosed with atrial fibrillation, you will have regular check-ups to make sure your symptoms are under control.

You may be given medicine to:

• control the rate and rhythm of your heart, such as beta blockers
• lower the risk of blood clots or stroke (anticoagulants)

Other possible treatments for atrial fibrillation include:

• burning, freezing or using high-energy electrical pulses to destroy a section of your heart (ablation)
• using electricity to reset your heart rhythm (electrical cardioversion)
• having a pacemaker or implantable cardioverter defibrillator (ICD) fitted

Sometimes atrial fibrillation can be caused by another health condition or medicine. In these cases, treating the condition or stopping the medicine can improve the symptoms.

In addition to treatment you might need, there are things you can do yourself to help with symptoms of atrial fibrillation and lower the chances of complications.

• avoid triggers such as caffeine, spicy food, stress, dehydration and lack of sleep

• try to keep to a healthy weight

• eat a balanced diet

• exercise regularly – aim to do at least 150 minutes of moderate exercise a week, like walking, bike riding or gardening

• do not smoke

• do not drink too much alcohol

• do not exercise too much or too hard – this can trigger atrial fibrillation

Atrial fibrillation is caused by a problem with the electrical system that makes your heart beat.

Anyone can get it, but you may be more likely to get it if:

• you're aged 55 or older
• you're a man
• you're living with obesity or overweight
• you smoke
• you take certain medicines, such as levothyroxine, lithium or some asthma medicines like salbutamol
• you do endurance sports like long-distance running, cycling or skiing

Atrial fibrillation can also be caused by another condition such as:

• high blood pressure
• heart conditions like heart failure, mitral valve problems or Wolff-Parkinson-White syndrome
• a heart attack
• chronic kidney disease
• an overactive thyroid (hyperthyroidism)
• diabetes
• sleep apnoea

There is currently no cure for atrial fibrillation, but treatment should help manage the symptoms and lower the risk of complications like blood clots, stroke and heart failure.

You should be able to carry on doing most things as usual, including exercise. But avoid intense exercise and try not to exercise when you're having symptoms of atrial fibrillation. Check with your doctor if you're not sure what exercise you can do.

If you drive you may need to tell the DVLA that you have atrial fibrillation. Your doctor will be able to tell you if this applies to you.

There might also be other practical things you need to think about if you have a heart condition, like travelling abroad with medicine, and changes to health or travel insurance.

While atrial fibrillation can usually be managed, living with a heart condition can be worrying.

You may find it helpful to get support from other people with atrial fibrillation, either at a local support group or online.

There are also national charities that can offer information, help and support.

Information and support for anyone affected by a heart condition.

• Website: www.bhf.org.uk
• British Heart Foundation: Heart Helpline (call, email or webchat with a cardiac nurse)
• British Heart Foundation: our online community
• British Heart Foundation: support with everyday life

Information and support for young people diagnosed with heart conditions and their families.

• Website: www.myheart.org.uk
• Helpline: 01737 363222

Symptoms of atrial fibrillation include an irregular heartbeat, a fast heartbeat, palpitations, dizziness and shortness of breath.

Atrial fibrillation is usually treated with medicines to control the rate and rhythm of your heart, and to lower the risk of blood clots or stroke.

Anyone can get atrial fibrillation, but it's more likely if you're over 55, take certain medicine or smoke. It can also be caused by other conditions.

Tests for atrial fibrillation may include checking your heart rate, an electrocardiogram, echocardiogram, chest X-ray and blood tests.