Could You Have AFib and Not Know It?   

Could You Have AFib and Not Know It?

Doctor using a stethoscope to listen to a patient's heart.
Clinical Contributors to this story:
Harmony Leighton-Seiffer, D.O.

You could have atrial fibrillation (AFib) and not realize it. As many as 2 million people may be undiagnosed with AFib. It’s the most common of several types of irregular heartbeat, or arrhythmia, which happens when a heart beats too fast, too slow, or in another abnormal way.

“It basically means your heart beats out of rhythm,” says Harmony Leighton-Seiffer, D.O., a cardiologist at Hackensack Meridian Pascack Valley Medical Group in both Emerson and Paramus, New Jersey. AFib is a risk factor for more serious medical conditions that may include heart attack or heart failure, stroke and dementia.

AFib occurs when the heart’s chambers beat at different rates—when the two atria or top chambers aren’t beating in sync with the two ventricles on the bottom. A normal heartbeat goes, “top-bottom, top-bottom,” Dr. Leighton-Seiffer says, but with AFib, that rhythm gets off track.

Types of AFib

Cardiologists usually refer to four types of AFib, Dr. Leighton-Seiffer says, based on duration:

  • Paroxysmal: You go “in and out of AFib.” It may be a short burst, last for a few hours or a few days, but no longer than seven
  • Persistent: AFib that lasts at least seven days straight
  • Long-standing: AFib that lasts a year or more
  • Chronic AFib: It is consistent, meaning all the time

How to Know if You Have AFib

Dr. Leighton-Seiffer says you might feel palpitations—the sensation or knowledge that your heart is beating out of rhythm, fluttering or beating too fast. You can usually detect this if you take the pulse in your neck or wrist. You could also feel lightheaded or fatigued or experience shortness of breath or chest pain.

AFib may be noticed during a routine office visit. “Upon examination, we can hear the irregular heartbeat or see the irregular rhythm on an EKG—an electrocardiogram administered painlessly by wearing a few electrode patches on your body for a short time,” Dr. Leighton-Seiffer says. She says some patients discover their AFib through wearable smart devices like the Apple Watch. “These smart devices are game changers in a good way.”

Some people have no idea they are living with AFib because they are asymptomatic or have no symptoms, Dr. Leighton-Seiffer says. “Some are chronic ‘AFibbers,’ meaning they are in AFib all the time and either tolerate or have no symptoms,” she says. “Still, others are super-symptomatic and can tell me the exact second AFib starts.”

Some patients may not realize they have AFib if they are on medications to control their heart rate, such as beta-blockers or calcium channel blockers, which keep heart rates slow and can mask symptoms. “They may not feel their heart racing,” she says. “That’s why no patient leaves my office without having an EKG.”

Why to Get Tested for AFib

It’s crucial to diagnose this condition because even patients with no symptoms can have a stroke. “In AFib, the top of the heart is fibrillating,” says Dr. Leighton-Seiffer. “When that happens, blood in the top chamber can pool and form clots that can travel to the brain and cause a stroke.”

AFib is themost common arrhythmia as people get older. Other risk factors connected to this condition include:

  • High blood pressure or hypertension
  • Heart failure and heart valve diseases
  • Coronary artery disease
  • Excess body weight or obesity
  • Diabetes
  • Hyperthyroidism
  • Chronic kidney disease
  • Smoking
  • Moderate to heavy alcohol use
  • Viral infections
  • Sleep apnea

Treatments for AFib

Lifestyle recommendations that can improve AFib include maintaining a healthy weight, being physically active, eating a heart-healthy diet, managing stress, quitting smoking, and minimizing alcohol use.

Common treatments include:

1. Medications

Medications may include beta-blockers and calcium channel blockers, which reduce heart rate and minimize symptoms while in AFib. “The mainstay of treatment may include a blood thinner to prevent a stroke,” Dr. Leighton-Seiffer says. “It is also aimed at either controlling heart rates while in AFib, known as rate control strategy, or restoring normal rhythm, called rhythm control strategy.”

2. Cardioversion

There are two main types of cardioversion:

  • Chemical cardioversion, which uses medication to restore normal heart rhythm.
  • Electrical cardioversion, which uses low-energy electrical shocks to help return to a normal heart rhythm.

3. Ablation

Also called catheter, cardiac or radiofrequency ablation, the procedure utilizes radiofrequency energy—think microwaves and heat—to put a small scar in the area of the heart that causes the irregular heartbeats. This method is often very successful at restoring and maintaining normal rhythm.

“Most people with AFib go on to live a normal, otherwise healthy life,” she says. “If you are diagnosed with AFib, your doctor can decide which treatment option is right for you through joint decision-making.”

Next Steps & Resources

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.


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