Atrial fibrillation (AFib) is a common heart rhythm disorder where the upper chambers of the heart (the atria) beat irregularly and out of sync with the lower chambers. It may feel like fluttering, a racing heart, or just fatigue or shortness of breath—or it might cause no symptoms at all.
But it’s not harmless. This irregular rhythm can cause blood to pool in the heart, increasing the risk of blood clots and stroke. While AFib is more common in older adults, it’s now being diagnosed more often in younger people too.
Why It Matters
AFib increases stroke risk significantly, which is why stroke prevention is the first priority. Doctors use a scoring tool called CHA₂DS₂-VASc (CHADS-VASc, for short) to decide whether a blood thinner is needed. If you’re over 65 or have diabetes, high blood pressure, or a prior stroke, anticoagulation is usually recommended.
How It’s Treated
- Blood Thinners (Anticoagulants):
- Newer drugs like apixaban (Eliquis) and rivaroxaban (Xarelto) don’t require blood tests. Warfarin is used in some cases but needs regular blood checks to make sure your blood doesn’t get too thin or too thick. Studies suggest apixaban may offer better stroke prevention with lower bleeding risk.
- Rate vs. Rhythm Control:
- Medications may be used to either slow the heart rate or reset it to a normal rhythm. If symptoms persist, electrical cardioversion may be tried.
- Ablation:
- A minimally invasive procedure that targets faulty heart signals. It can reduce symptoms and hospital visits, especially when meds aren’t enough.
What You Can Do
- Take your blood thinner as prescribed—even missing a few doses increases your stroke risk.
- Follow up regularly—AFib needs regular monitoring, not just one-time treatment.
- Let your doctor know if symptoms change—palpitations, fatigue, or shortness of breath could mean your medications aren’t working or AFib is worsening.
- Manage underlying issues—high blood pressure, diabetes, and untreated sleep apnea can all worsen AFib.
- Avoid triggers—excess alcohol, caffeine, or stimulants.
Questions You May Want to Discuss With Your Doctor
- What should I know about my CHADS-VASc score?
- How do you decide which blood thinner is right for my AFib, and what are the pros and cons of this option of blood thinner?
- Would rate control or rhythm control be better for my AFib?
- When should we consider ablation for my AFib, now or if my medications don’t work?
- What should I monitor for while on blood thinners?
- What symptoms should make me call you or go to the ER if I’m on blood thinners?
- What steps can I take to lower my chances of AFib getting worse?
- Should I be screened for sleep apnea?