What Does AFib Feel Like?
If you have atrial fibrillation (AFib), you could have a sensation of a pounding heart, and your heart will feel like it is racing or beating very irregularly.
Common symptoms of atrial fibrillation:
- Highly variable blood pressure
- Dizziness or lightheadedness, fainting spells
- Shortness of breath at rest or with exertion
- Episodes of fatigue
- Palpitation or fluttering
- Chest pain, pressure, or tightness
Although these are common symptoms, there are many patients who have no symptoms related to their AFib. They may incidentally note an irregular or rapid pulse. Even without symptoms, AFib is a dangerous heart rhythm that needs medical treatment by a cardiologist specializing in abnormal heart rhythms.
Atrial fibrillation is an abnormal heart rhythm that comes from the heart's top left chamber. The heart typically beats 60 to 100 times a minute when at rest. During AFib, the upper and lower chambers of the heart become out of synch and disorganized, causing the upper chambers to beat nearly 600 times a minute and the lower chambers to beat 60 to 200 times a minute.
Atrial fibrillation is associated with frequent hospitalizations. There's a one in five chance of being hospitalized due to atrial fibrillation every year.
There is a 1 in 3 lifetime risk of developing AFib, and the risk rises significantly every year beyond age 65.*
Please note, if think you could be having a heart attack, call 911.
Joshua Rutland, MD, a cardiologist specializing in heart arrhythmias at CHRISTUS Trinity Clinic in Tyler, provided the following information.
Anatomy of the Heart
Understanding the anatomy of the heart helps you understand AFib and its complications.
The heart has two upper chambers called the right atrium and left atrium. The two bottom chambers are called the right ventricle and left ventricle.
The bottom heart chambers are big, thick, and muscular, and these serve as the main pumping chambers for the heart. All the veins in the body return the deoxygenated blood to the heart through the superior and inferior vena cava into the right atrium. The blood then flows through a valve into the right ventricle which is the main pump that sends the blood to the lungs to get oxygen. The blood then returns to the left atrium, flows through another valve into the left ventricle, and then the left ventricle acts as the main pump out to the body to supply it with blood. This is the basic plumbing of the heart.
The electrical system starts in the upper right corner of the right atrium with a structure called the sinus node or SA node. This is the heart’s own pacemaker that all people are born with. It functions to regulate the heart rate which is typically between 60 to 100 beats a minute at rest. The sinus node sends signals out in a very coordinated/regular fashion, creating the normal heart rhythm. The top and bottom chambers are electrically separate from each other except for a single connection in the center of the heart called the AV node. This structure sends the signal from the upper chambers to the bottom chambers (left and right ventricles).
AFib in the Heart
AFib is an abnormal heart rhythm that is not generated from the sinus node in the right atrium but rather originates from the left atrium. Tissue in the left atrium, most commonly from the pulmonary veins (which are the veins that return blood from the lungs to the left atrium), sends out its own electrical signals to stimulate the heart to beat.
These are the signals that trigger AFib. Unlike normal rhythm, the AFib signals are chaotic and irregular, beating much faster at nearly 600 beats a min in the upper chambers. Not all of these signals are transmitted to the lower chambers (the ventricles) which are the main pumps to move blood through the body. This results in the upper and lower chambers no longer working together synchronously. It is this chaotic, asynchronous rhythm that affects how the normal ventricles pump and leads to the typical symptoms of AFib.
Unknown Cause
The underlying cause of AFib remains unknown despite the fact that it is very common in the general population. Unfortunately, AFib is a progressive disease. It typically begins with short episodes interspersed between long periods of normal heart rhythm. This is known as paroxysmal AFib. Over time, these episodes begin to occur more frequently and last longer in duration. This is known as persistent AFib. If left untreated, some patients will progress to being in AFib continuously without any periods of normal rhythm. Eventually, this can become permanent AFib.
Early identification and treatment of AFib are key to maintaining normal heart rhythm.
Atrial Fibrillation Complications
Stroke
Atrial fibrillation can cause a risk for stroke because the irregular heart rate in the upper chambers of the heart can lead to poor circulation.
There is a part of the heart in the upper chamber called the left atrial appendage closure. When poor circulation occurs within this chamber, blood can become stagnate, which can form a clot.
If clots form in this chamber of the heart, they can then break loose and move into the main circulation of the body, which goes directly from the heart to the brain. If a blood clot moves into the brain, it can block a small artery, resulting in a stroke.
Between 20-30% of all strokes caused by clots are due to AFib.*
Heart
Atrial fibrillation can cause electrical signals within the heart to beat fast for several hours. This causes the heart muscle to work much harder and faster than normal, for a prolonged period of time.
Luckily, the heart muscle is powerful and can last for hours, going very fast. But unfortunately, the heart muscle will weaken if left unchecked, and if the fast heartbeat continues.
About 20 percent of people who develop atrial fibrillation develop heart failure.*
Dementia
There is a significant association with risks for dementia related to atrial fibrillation. Atrial fibrillation can damage the brain, affecting memory, language skills, and concentration.
This issue can affect everyday life, and the condition can be either mild or severe depending on symptoms.
Studies have shown that adults with atrial fibrillation are more likely to have cognitive declines than those not dealing with dementia.
What to do if you think you have a heart condition
If you have chest pain and think you could be having a heart attack, call 911 immediately.
If you suspect you could have heart disease or atrial fibrillation take the necessary steps to receive a diagnosis early. Early detection is critical. Talk to your primary care provider to address concerns about your heart and to get referred to a cardiologist if needed.
You can also take the CHRISTUS heart assessment to learn more about your heart health.
Heart Health Assessment
Take a health assessment to measure your heart health. The CHRISTUS Health heart assessment measures your risk of heart disease by asking simple questions.