Jefferson University Hospitals

Atrial Fibrillation Signs, Symptoms, Treatments

Signs, Symptoms and Diagnostic Tests

The signs and symptoms of atrial fibrillation are variable, depending on the person. Some people are in atrial fibrillation and aren't even aware of it, whereas other people have significant symptoms. The most common symptom that people feel is palpitations, or a fluttering sensation in the chest. People are usually aware of an irregular heartbeat; they're also aware of their heart beating faster than usual.

Besides palpitations, people sometimes feel:

  • Lightheaded and/or almost faint
  • Shortness of breath, often times with exertive activities such as walking up a flight of stairs
  • Chest pain ranging from mild to severe

The only way to know for sure if you have atrial fibrillation is to have a Jefferson physician perform a painless test called an electrocardiogram (ECG or EKG), which measures the electrical activity of the heart.

During an ECG, sensitive electrodes are placed on your chest. These electrodes pick up the electrical impulses generated by your body that cause your heart to beat. The impulses are then transmitted to a device that records them on a piece of paper called an ECG strip. By examining the specific pattern of electrical impulses traced on the ECG strip, your physician can tell for certain whether you have atrial fibrillation.

Treatment Options

There are several options for managing atrial fibrillation. At the Jefferson Heart Institute, we first assess your risk of having a blood clot or a stroke. Then we decide whether or not you need blood-thinning agents to reduce your risks back down to normal.

Aside from application of blood-thinning agents, control of atrial fibrillation symptoms may be achieved either by attempting to maintain normal rhythm or employing a strategy of heart rate control. The treatment strategy of restoring the heart's normal rhythm is called cardioversion. This can be done either through the use of electrical stimulation (direct-current or DC cardioversion) or through pharmacologic (drug-based) therapy. For many, one or the other of these measures will work to convert the heart to normal rhythm.

If you have chronic atrial fibrillation, in which it's very hard to return the heart to normal rhythm, then your physician will concentrate on heart rate control. This treatment strategy is also good for those who have minimal or no symptoms or for whom have tried rhythm control and it hasn't worked. The medications that Jefferson physicians use to achieve rate control include beta-blockers, calcium channel blockers and digoxin.

A minimally invasive procedure that is called atrial fibrillation ablation is available if your symptoms are not responsive to drug therapy. The procedure takes approximately 4 to 6 hours to perform and usually requires an overnight hospital stay. The goal is to isolate electrical activity from the pulmonary veins, sites that often initiate or trigger atrial fibrillation.