Why AFib Matters

What are the consequences of atrial fibrillation (AFib)?

Although atrial fibrillation can feel weird and frightening, an “attack of AFib” usually doesn’t have harmful consequences by itself. The real danger is the increased risk for stroke. Even when symptoms are not noticeable, AFib can increase a person’s risks for stroke and related heart problems.

What causes atrial fibrillation?

Sometimes the cause of AFib is unknown. Other times, it is the result of damage to the heart's electrical system from other conditions, such as longstanding, uncontrolled high blood pressure or artery disease. AFib is also the most common complication after heart surgery.

View an animation of atrialfibrillation.

Usually, the most serious risk from AFib is that it can lead to other medical problems, including:

  • Stroke
  • Heart failure
  • Chronic fatigue
  • Additional heart rhythm problems
  • Inconsistent blood supply

Learn about the important connection between atrial fibrillation, high blood pressure and stroke.

How does AFib lead to stroke?

  • The heart quivers. The upper chambers (the atria) of the heart do not produce an effective, regular contraction.
  • The contraction fails. Imagine wringing out a sponge. Without a good squeeze, water will still be left in the sponge. In the same way, when a heart contraction is either too fast or too uneven, it doesn’t completely squeeze the blood from the atria into the next chamber.
  • Blood pools in the atria. Leftover blood remains in the atria and may pool there.
  • Risks of clotting go up. When blood has the opportunity to pool, it also has the opportunity to clot.
  • Clots can travel and cause blockages. If a blood clot forms in the atria, it can be pumped out of the heart to the brain, blocking off the blood supply to an artery in the brain, causing a stroke. This type of stroke is called an embolic stroke or some doctors call it a cardioembolic stroke.

How does AFib lead to heart failure?

Heart failure means the heart isn’t pumping enough blood to meet the body's needs. AFib can lead to heart failure because:

  • The heart is beating so fast that it never properly fills up with blood to pump out to the body.

As a result, when the heart doesn't efficiently pump the blood forward with strong contractions, symptoms develop because:

  • Blood can “back up" in the pulmonary veins (the vessels that return oxygen-rich blood from the lungs to the heart.) which can cause fluid to back up into the lungs.
  • When AFib causes heart failure, fluid in the lungs can cause fatigue and shortness of breath. Oxygen-rich blood is not being delivered to the body and brain, causing physical and mental fatigue and reduced stamina. Fluid also can build up in the feet, ankles, and legs, causing heart-failure related weight gain.

How does AFib lead to additional heart rhythm problems?

Basic answer: The heart’s electrical system stops working properly, and fails to keep the heart chambers in rhythm.

Thorough answer: Every heartbeat is controlled by the heart’s electrical system. To understand why atrial fibrillation is a problem, it is helpful to understand the normal patterns of the heart’s electrical system.

View an animation of a normal heartbeat.

The heart’s normal electrical pattern:

  • The current travels from top to bottom. The heartbeat starts at the top of the heart and – like an electrical wave – the current travels to the lower parts of the heart, signaling the tissue to contract.
  • The sinoatrial (SA) node starts the contraction in the top of the heart. The right atrium (top section of the heart) houses a group of cells called the sino-atrial node. In healthy adults, the SA node fires off between 60-100 heartbeats per minute. The electrical wave moves through the atria to “gatekeeper node."
  • The atrioventricular (AV) node regulates the timing of the lower portion of the heart. The AV node serves as a "gatekeeper" for all of the electrical pulses going through the atria (top sections) to the ventricles (bottom sections). The electrical pulses are delayed at the AV node before they are allowed to move into the ventricles. The delay gives the ventricles extra time to finish filling with blood before contracting.
  • The ventricles contract and pump blood out to the lungs and the body.

Electrical problems in atrial fibrillation:

  • In AFib, the SA node may not start the contraction. Instead, the contraction might start randomly in other areas of the atria or even in the pulmonary veins.
  • In AFib, the electrical current doesn’t flow in an organized top-to-bottom fashion. Instead, contractions are rapid and disorganized.
  • In AFib, the AV node often can’t regulate the chaotic current. It does its best to protect the ventricle from extra electrical impulses, but it can’t stop all of them. As a consequence, the ventricle beats more often than it should – giving rise to the noticeable symptoms of breathlessness and fatigue.
  • When the beat is off, the blood supply can be unpredictable. So, even though the ventricles may be beating faster than normal, they aren't beating as fast as the atria. Thus, the atria and ventricles no longer beat in a coordinated way. This creates a fast and irregular heart rhythm. In AFib, the ventricles may beat 100 to 175 times a minute, in contrast to the normal rate of 60 to 100 beats a minute.

The amount of blood pumped out of the ventricles to the body is based on the randomness of the atrial beats.

The body may get rapid, small amounts of blood and occasional larger amounts of blood. The amount will depend on how much blood has flowed from the atria to the ventricles with each beat.

Can AFib simply go away?

Yes, rarely "spontaneous remission" does happen; it simply goes away.However, it is still something you and your healthcare provider will want to monitor because some people live with AFib and do not feel the symptoms. However, the risks are still present.

Overall, most of the risks, symptoms and consequences of AFib are related to how fast the heart is beating and how often rhythm disturbances occur.

AFib may be brief, with symptoms that come and go. It is possible to have an atrial fibrillation episode that resolves on its own. Or, the condition may be persistent and require treatment. Sometimes AFib is permanent, and medicines or other treatments can't restore a normal heart rhythm.

But for all the reasons listed above, it is important to work with your healthcare provider to determine your treatment needs, and to understand your treatment options. It is also important to maintain a heart-healthy lifestyle and reduce your overall risks as much as possible.


Recent Discussions From The Newly Diagnosed Forum
emrefaks avatar

Hi all,

I'm a 9-day old AF rookie all the way from Turkey. I'm 47 and have been exercising many kind of sports since my childhood days. Nowadays, mainly running some half and full marathons, strength & conditioning workouts plus yoga as active recovery. 

I always had some palpitations, minor chest pain and the likes, therefore never skipped check-ups (including BT scans too) on regular basis and -all the times- been told that my heart was in perfect shape to maintain my active life. 


Until that Sunday night, 9 days ago...

11PM that Sunday night, I woke up with some major and unmanageble palpitations and waited until morning with a hope that it will soon get better but it did not. Then I drove to the ER at the regular hospital that I always used to go and faced the reality that my heart had been out of sinus rythm and went into AF. 3 hour-long medication did not reverse it and I've been moved up to the cardiological intensive care for further protocals. It took approximately 5 hours to get back to the sinus rythm through ongoing medication either taken orally or through vascular access. Doctors kept medicating for an extra 4 hours and then discontinue. From that point on, they started closely monitoring my situation for like 10 hours. Finally, I was discharged from the hospital and allowed to drive back home. 

Yesterday morning, I went to see my Cardilogist, who had been on holiday during my episode, to find out that:

1. I was a lucky one since my heart shouted that it had been hit by AF. She underlined there are incidents that AF comes without any syptoms but can be a cause of stroke or more serious heart diseases. At least we know who and where the enemy is... 

2. My prescription only includes beta-blockers and anti-arythmics but not blood thinners which was shockingly surprising to me. I even challanged her (BTW. she is a Professor, specialised on arthmia) that without thinners, I would have much bigger risk of stroke based on the things I've read on Internet. She very bluntly highlighted several times that each AF was different and it was "stupid" to treat each AF'ers in standart ways. Some patients might desperately need thinners but some don't, simply based on several other factors. 

3. Keeping a healthier mind is key. Otherwise, you will not be able to sleep efficiently, lose appetite (ie. not enough carb to feed to your heart) and always be in a negative mood only thinking and talking about your conditions which there is nothing you can stop it from being there! Hypochondria should be the last thing for any AF'ers to experience. Therefore I'm also given some light medications to keep my mind well.

4. Exercise in ways planned by your doctor helps a great deal. There are even some athletes that have been carried on playing with or without knowing that they had been an AF'er such as Larry Bird. We are not superstars but much simplier human beings therfore I already said a heartbreaking "Goodbye" to marathon. However this doesn't mean that I will quit running either. The formula I've been proived by my doctor: 220-47 (my age) = 173 is the maximum calculated HR (MCHR). However in my conditions; I'm adviced to start running on 50% of the MCHR which is around 90 BPM, almost a fast walking pace. If all goes well, I'll start increasing the % until 75% which will give me enough pace to start jogging at least. 

5. And finally, do not waste your time reading some bosh staff at Internet. I'm writting this post HERE (i.e. a very well trusted and informative publishment), as this was also suggested by my doctor as a part of my progress plan. Where I live (ie. Turkey) is full of some silly content regarding AF unfortunately. At every article I've ever read, there was major drama which made me feel even much worse. And believe me, after a while your body start emulating eveything you read. I cannot tell you how many times I thought my brain had been shot by clot or my energy levels had been sub-zero. But it was all illusive because of the things I've been exposed to heavily. 

To cut a long stroy short: I'd never wanted to end up being an AF'er. But whatever happened happened and there is nothing I can do to send this back. I'm new and aware that I will have some tough times along the way. However, I have a plan and intention to make things as comfortable as my conditions will allow. 

Nice to meet you all, Emre  




58brendaB avatar

Hi I am new here and I just want to introduce myself.
--- Not really sure where I am supposed to post --- Sorry I have in a couple places


A little background , I am 61 now ( 2019 )
I have had AF since 2014 
Once a yr prior I went to the ER with what they said was tachycardia. They sent me home saying I was under stress - I had had a loss in the family.

Two yrs later in 2014 I was sitting at the table and my heart was racing.

Decided to go to the hospital because I was attempting to take my BP with a home cuff and it would not register.

My heart rate at the hospital was over 220
I converted approx 7 hours later with medication. I was admitted and spent 3 days.Hospital Dr said I needed metoprolol and blood thinners. In his words OR I was going to die.( NICE TO HEAR AS I WAS ALREADY SCARED)

Ever since my first bout of AF I have had ringing in ONE EAR 24/7 365
Cardiologist says it was unrelated, however it happened at that exact time & I have no reason to believe it isn't related.

I went to ENT, 2 neurologists , Ear Dr, and PCP had every test known including a brain scan all found nothing wrong. BUT, It persists to this day.


I had a cardiologist from my previous episode of tachycardia & I went to see him and he told me there was a 5 point system to determine treatment and I was under 1.
He suggested Propanolol ( 10mg) AS NEEDED and an aspirin daily. The aspirin was lowered to ½ and then eliminated due to a new study that it is ineffective in treatment.He said when I am 65 we will re-evaluate treatment.

I do NOT have HBP ( it does spike in an episode ) or any other conditions. I am overweight

I have had a stress test ,EKG'S and a halter monitor a couple times
I take

Magnesium Oxide 600mg.




Sometimes potassium and B12 and fish oil

& drink A LOT of water
No caffeine

I do have episodes of AF
In the last 2 years I have had 5
I take pill as soon as I feel it and generally convert within a hour & all is well.UNLESS, I have a long bout which lasts a couple maybe 4 hours + and required 2 pills.


For days sometimes weeks I am off.

I have some breakthrough palpitations and I am SO exhausted I can't function.

I am woozy – not light headed more like swaying  on a ship. Not moving helps.In turn I get nervous anxiety, then sometimes palpitations.

I do feel it is related to the ringing in my ear & is triggered with AF But that is of little comfort. They say It takes time to “balance out”

I have tried ( Dr suggested) water-pills and mucinex as well as benadryl sometimes it will help a little Others times not at all.

Does ANYONE else have this kind of experience ? I really need some input!!! I am week 3 after an episode and this one is really difficult.

DukesDad avatar

I was diagnosed with paroxysmal AFib almost 4 months ago and have had 19 episodes since.  Meds have reduced the episodes greatly, with the most recent 6 Afib episodes averaging 6 to 12 hours, once every 7 days.  Over half have occurred between midnight and 6 am, so a sleep apnea study has been ordered.  The episodes have not proven to be debilitating and have been dealt with by just limiting my activity.


My wife and I have been planning a much needed 2 week international trip to Spain and Majorca in October.  My cardiologist didn't say no when I asked, but he didn't seem that enthusiastic either.  His concern seemed to be more over the long flight at altitude serving as a trigger.  He does not consider me to be as being at great risk of stroke since I have only a single risk factor. and am in good health other than a little overweight.


Is traveling internationally with Afib of high concern?  Should I postpone the trip till my Afib episodes are under better control?

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