Early symptoms of atrial fibrillation

The early symptoms of atrial fibrillation (AFib or AF) may occur rarely, come and go every once in a while, or they may be an ongoing concern lasting years. Moreover, AFib may be asymptomatic, but when symptoms are present they include the following:

·         Palpitations (an uncomfortable sensation that the heart is racing, pounding, fluttering, skipping a beat, or beating too hard or too fast).

·         Fast and abnormal heartbeat (100-175 beats per minute).

·         Lightheadedness.

·         Severe fatigue.

·         Shortness of breath.

·         Chest pain.

·         Weakness.

·         Decreased ability to exercise.

·         Dizziness.

·         Confusion.

·         Lack of energy.

These symptoms take place when two of the four chambers of the heart – in this case the upper chambers, or atria – beat out of sync with the ventricles – the lower chambers. AFib the most common form of arrhythmia, and can be itself categorized in four different types.  

Atrial fibrillation types


Defective electrical signals and fast heartbeat start suddenly, last from a few minutes to hours, and stop on their own. Symptoms – either mild or severe – resolve in about one week, but generally in less than 24 hours.


Irregular heart rate goes on for more than a week. May stop by itself or require treatment to stop.

Long-standing persistent

Continues and lasts longer than 12 months.


Normal heart rate cannot be restored with treatment.


There isn’t a single cause for AF; in fact many different conditions, procedures, and factors are believed to contribute to its onset, such as:

·         Heart surgery.

·         Cardiomyopathy.

·         Chronic lung disease.

·         Congenital heart disease.

·         Coronary artery disease.

·         Heart failure.

·         High blood pressure.

·         Pulmonary embolism.

·         Aging.

·         Obesity.

·         Being of European descent.

·         Diabetes.

·         Ischemic heart disease.

·         Hyperthyroidism.

·         Chronic kidney disease.

·         Heavy drinking.

·         Enlargement of the chambers on the left side of the heart.

·         Heart attack.

·         Abnormal heart valves.

·         Medications, caffeine, tobacco, illegal drugs.

·         Sick sinus syndrome.

·         Viral infections.

·         Sleep apnea.

·         Pericarditis.

·         Family history.

·         Rheumatic heart disease.

Women are more likely to experience AFib because they tend to live longer than men. In addition, research published in the BMJ highlights atrial fibrillation as risk factor for cardiovascular disease and death in women compared with men. This condition causes over 750,000 hospitalizations and approximately 130,000 deaths each year in the U.S., at a cost of %6 billion. Left untreated, AF may result in stroke or heart failure, as well as an increase of $8,705 in healthcare costs as compared to people who do not have it. Thus the importance of seeing a doctor if you experience the early symptoms of atrial fibrillation, which can be diagnosed with the following tests:

·         Physical exam.

·         Electrocardiogram.

·         Echocardiogram.

·         Blood tests.

·         Stress test.

·         Chest x-ray.

People whose symptoms come and go may require a special monitor (Holter, portable event, or transtelephonic) to record irregular electrical activity in the heart. The physician can prescribe a treatment for AFib based on his/her diagnosis, as well as on the frequency and severity of symptoms.

Treatment for atrial fibrillation


·         Rhythm control:

-        Procainamide (Pronestyl).

-        Disopyramide (Norpace).

-        Leecainide acetate (Tambocor).

-        Propafenone (Rythmol).

-        Sotalol (Betapace).

-        Dofetilide (Tikosyn).

-        Amiodarone (Cordarone).

·         Rate control:

-        Digoxin (Lanoxin).

-        Beta-blockers such as metoprolol (Toprol, Lopressor).

-        Calcium channel blockers such as verapamil (Calan) or diltiazem (Cardizem).

·         Anticoagulants:

-        Warfarin (Coumadin).

-        Warfarin alternatives.


·         Electrical cardioversion.

·         Cardioversion with drugs.

·         Pulmonary vein ablation.


·         Permanent pacemaker.

Left atrial appendage closure



·         Maze procedure.

Lifestyle changes

·         Avoiding activities that trigger AF.

·         Quitting smoking.

·         Drinking alcohol moderately.

·         Limiting caffeine.

·         Monitoring blood pressure.

·         Keeping a healthy weight.

·         Eating heart-healthy food (fruits, vegetables, whole grains, low in salt and solid fats).

·         Monitoring blood sugar.

·         Exercising.

Goals of treatment

·         Preventing blood clots.

·         Controlling rate control (the number of times per minute the ventricles contract).

·         Restoring normal heart rhythm.

·         Treating underlying conditions that contribute to AFib.


People who have the early symptoms of atrial fibrillation should consult a healthcare provider to be properly diagnosed and follow a treatment program as prescribed by the physician.

Related: Early symptoms of heart failure