Most of the time, we never give our heart a thought; it quietly does its job of pumping blood throughout our body. But if you ever feel that your heart is beating differently or you just don’t feel right, get it checked to rule out a more a serious problem.

Atrial fibrillation is the most common type of heart arrhythmia; it’s an irregular heartbeat in which the upper chambers of the heart beat chaotically and much too fast. It is often described as a fluttering, flip-flopping, skipping or racing sensation. AFib is a chronic condition that often affects people over age 60 and basically means your heart’s electrical system isn’t working properly. AFib is a progressive disease that can get worse over time and lead to stroke, heart failure or blood clots if not treated.

In AFib, the electrical system sends out many different signals in an erratic way instead of its usual steady pattern. The upper chambers (or atria of the heart) beat irregularly and very rapidly and do not pump out all of the blood to the ventricles or lower chambers. In turn, the ventricles begin beating faster in an attempt to keep up. Blood can pool in the atria and potentially form clots,which can then travel to the brain and cause a stroke. 

There are four types or stages of AFib. Paroxysmal AFib is a sudden episode that lasts from a few minutes to a few days. Episodes can occur repeatedly over time. Left untreated, it can progress to persistent AFib. Persistent AFib lasts longer than seven days and requires treatment to restore normal heart rhythm. Long-term Persistent AFib is when symptoms continue for at least 12 months without resolving on their own. Permanent AFib, or chronic AFib, is when normal heart rhythm can’t be restored even with treatment.

 As a result of the heart’s inefficient pumping, the body receives less oxygenated blood, and one may experience some of the following symptoms: heart racing; palpitations; fluttering or a feeling like a fish is flopping in your chest; shortness of breath; extreme fatigue or weakness; dizziness or lightheadedness; chest pain; exercise intolerance; or irregular pulse.

There are many risk factors that increase one’s chances of developing AFib. Age is the most important factor, especially for those age 65 and older, along with: high blood pressure; obesity; diabetes; smoking; excess alcohol consumption; obstructive sleep apnea; hyperthyroidism disease; chronic kidney disease; genetics or a family history of AFib; heart disease like congestive heart failure or coronary artery disease; having a serious illness that requires hospitalization; and a lack of physical activity or conversely, extreme exercise routines over a long period.

Women may experience AFib differently than men. They tend to have more intense symptoms like severe shortness of breath, fatigue, weakness, dizziness, sweating and anxiety. Men often report a sudden onset of symptoms like palpitations, extreme fatigue, a rapid pulse, reduced exercise capacity or chest discomfort. Women with AFib tend to have a lower quality of life, with more debilitating tiredness and breathlessness that disrupts their daily activities. Women are often diagnosed much later than men or have their symptoms dismissed. Consequently, they have a higher risk of stroke and heart failure than men.

To diagnose AFib, doctors use an electrocardiogram or EKG, which graphs the electrical signals in the heart. They will also do a physical exam, review medical history and check bloodwork. Patients may be asked to do an exercise stress test, have a chest X-ray or wear a Holter monitor to record the heart’s electrical activity for a few days. Often AFib is picked up by smartwatches or similar wearable monitors; these devices can provide valuable data to your doctor. 

Treatment for AFib may include medication, cardioversion therapy or a heart procedure. Medications like beta blockers, calcium channel blockers and blood thinners can help control the speed of the heartbeat, reset the heart rhythm or prevent blood clots, making you more comfortable. Cardioversion therapy involves resetting the heart rhythm with drugs or by sending electric shocks to the heart through paddles or patches placed on the chest. There are many different procedures or surgical methods for AFib.

Your doctor may recommend an ablation to control your AFib. An ablation is a procedure that creates scar tissue in your heart that blocks abnormal electrical signals so your heart can beat in a normal rhythm. You may also need a pacemaker after ablation. 

For those who can’t tolerate blood thinners, a doctor may recommend a left atrial appendage closure where the left atrial appendage, a small pouch in the left atrium of the heart, is closed off. This appendage is where most AFib related clots form. AFib sometimes returns after an ablation; if this happens, another ablation or a different treatment may be recommended. Not everyone is a candidate for each type of treatment. Your doctor will decide which treatment is best based on your specific symptoms and overall health. The main goals of treatment are to prevent blood clots and reduce symptoms.

 Lifestyle changes can keep AFib from worsening. Maintaining a healthy weight, limiting alcohol consumption, stopping smoking, exercising and treating high blood pressure, sleep apnea and diabetes can all make a difference. There is no permanent cure for AFib though it can be managed. Treatment lowers your risk of stroke and keeps you from experiencing symptoms.