Atrial Fibrillation in Cardiology (AFib)

How much Active Can I Be With Atrial Fibrillation ?

You probably have questions about how atrial fibrillation (AFib) will affect your day-to-day life. Some people fear that exercising, having sex or engaging in physical tasks at home or at work might trigger an AFib episode or hurt their heart.

The good news is that, in general, it’s perfectly safe – and good for your health – to stay physically active while living with AFib. But everyone’s different, so talk with your health care team about finding the right level of activity for you.

Atrial Fibrillation in Cardiology (AFib)

Tips to Live Better With Atrial Fibrillation

Talk with your doctors about how AFib is affecting your life?

Your care team’s main goal is to help you live a healthier life. They will know only what you tell them about how your condition is affecting what you do and how you feel.

Tell your care team exactly how you feel, what your fears are about AFib, and how AFib has changed or limited your activities. They will use this information to better tailor your treatment.

Many people with AFib also have heart failure. Ask about how to pace yourself and when to report in.

Know your Stroke Risk

AFib can increase your chance of having a stroke. Your care team is in the best position to calculate your risk.

Most people with AFib may need to take a prescription blood thinner to prevent clots from forming, but some need no medications. Discuss with your care team in detail to understand the right options for you.

Take your medications exactly as prescribed

Medications are an important part of managing AFib, both to control your heart rate and risk of stroke. But medications work only if you take them the right way. Always tell your health care team about any side effects. Also, don’t stop taking or make changes to your medications without talking to your health care team first.

Over time, AFib can change the shape and size of the heart and how electrical signals are communicated. Medications can help regulate AFib, but which ones you take or the amount sometimes needs to be changed. Therapies such as cardioversion to try to “kick” the heart into a normal rhythm or ablation may be considered to help you improve your symptoms.

Take steps to manage other medical conditions.

These include high blood pressure, high cholesterol, thyroid disorders, diabetes and heart failure. Also ask your care team about sleep apnea because many people with AFib also have this sleep disorder. All these conditions need to be addressed and treated if you have them.

Eat a heart healthy diet.

It’s very important to be mindful about the types of foods fueling your body. Talk with your health care team about how to adopt a healthy eating plan that is low in fat and salt. Ask whether talking with a dietitian would be helpful.

Keep in mind that alcohol and some stimulants can trigger episodes of AFib.Common AFib Triggers

Certain things can trigger atrial fibrillation and acute episodes in people who already have it. For example:

  • Infections
  • Heart failure
  • Drinking too much alcohol
  • Skipping doses of medications aimed to control AFib
  • Smoking or taking stimulants

Shed extra pounds

Studies have shown that losing weight, if needed, can help ease symptoms and episodes of AFib in some people. It may even reduce the amount of medication you need to take.

Find an exercise plan that fit your life

Talk with your health care team about what exercise routine is best for you, including the type and frequency of activity. Moving your body also helps boost feel-good hormones and can set you on the right path to make healthy food choices. In fact, studies show that people with AFib who exercise are better able to manage their condition and go about usual activities than those who are not active.

Some people with AFib say they are wary of exercising for fear that it will make their condition worse. While it may not be a good idea to take part in very vigorous workouts, strengthening your heart is important, so find time to talk with your health care team about what’s the best choice for you.

Manage Stress

Excessive worry and intense bouts of anger or anxiety can make AFib worse due to faster heart rates. Of course, the start of symptoms themselves can also make you anxious.

Try to find ways to lower stress. For example, go for a walk, listen to music, exercise, or find ways to better manage your time. Research has shown that for some people with AFib, yoga helps them feel better and lowers heart rate, blood pressure, and anxiety/depression scores.

Stay connected socially

Don’t let AFib define you. Continue or pursue new hobbies and take part in community or faith-based activities. Many people say doing so helps them to cope and keep a positive outlook.

Get Support and accept help when it is offered

Other people may not understand how AFib makes you feel or affects your ability to do certain things or what to do to help. Try to anticipate your needs ahead of time so you know what might be most helpful if friends and family ask what they can do.

Consider bringing someone to your health visits to help you remember what was said and think of other questions to ask. Also, walk with a buddy for motivation to exercise, or reach out to other people with AFib for support.

Atrial Fibrillation in Cardiology (AFib)

Atrial Fibrillation and Living

Living with AFib can affect many different aspects of your life, including your stamina, relationships and emotional health. But taking an active role in your care can help you feel better and more in control.

In this section, find Tips to Live Better With AFib. Also, if you are concerned about what types of activity you can do, check out How Active Can I Be?

Common AFib Triggers

Certain things can trigger atrial fibrillation and acute episodes in people who already have it. For example:

  • Infections
  • Heart failure
  • Drinking too much alcohol
  • Skipping doses of medications aimed to control AFib
  • Smoking or taking stimulants
Atrial Fibrillation in Cardiology (AFib)

Choosing Blood Thinners or Left Atrial Appendage (LAA) Closure

For most people with atrial fibrillation, blood thinners lower the risk of stroke. However, blood thinners (also called anticoagulants) can cause bleeding.

Some people with a very high risk might consider a procedure called left atrial appendage closure that places a device in the heart to prevent strokes.

If you have atrial fibrillation, use this Stroke and Bleeding Risk Calculator together with the decision aids below to help you decide with your care team what treatment is right for you.  

If you are living with atrial fibrillation and a very high, high, moderate, or low risk of stroke, use the tools in the sections below.

Atrial Fibrillation in Cardiology (AFib)

More Options to Prevent Stroke

If you are at high risk for stroke due to AFib and are unable to take blood thinners because of repeated bleeding or a high risk of bleeding, then a left atrial appendage closure device may be an option for you.

The left atrial appendage is a small, ear-shaped pouch in the heart where blood can collect. Clots that cause strokes in patients with AFib often form there.

By placing an umbrella-like device in the left atrial appendage using a minimally invasive procedure, the chance of stroke from AFib can be lowered without the need for long-term use of blood thinners.  Ask your care team to see if left atrial appendage closure is an option for you.

Atrial Fibrillation in Cardiology (AFib)

Medications to Prevent Stroke

Medications to prevent or treat blood clots and stroke include blood thinners, also called anticoagulants.

Blood thinners work by reducing the ability of the blood to clot. But as with all medications, blood thinners have side effects. In preventing blood clots from forming, there is also a higher chance for bleeding in some people. Usually, the bleeding is minor – for example, bruising more easily, or having a nosebleed or cut that takes longer to stop bleeding. However, some bleeding can be serious.

For many patients, the benefits of taking a blood thinner far outweigh the risk of bleeding, according to cardiologists. Even when bleeding does occur, it can usually be managed and is rarely life-threatening.

But research and clinical experience suggest that many patients – and even some clinicians – may worry more about the possibility of uncontrolled bleeding when taking a blood thinner than on the benefit of stroke prevention. It’s important to put these risks in context.

What we mean by Risk ?

Risk is the chance, or likelihood, that something will happen.

For example, people over 80 years of age have a 10% risk of developing AFib. In other words, 10 out of 100 (or 1 in every 10) people in this age group will have AFib.

Using the CHA₂DS₂-VASc risk scoring (a tool used to predict the chances someone with AFib will have a stroke), if you are 75 years or older and have diabetes and high blood pressure, your score is 4. This means your risk of having a stroke in the next year is nearly 5%‐4.8% to be exact. In other words, among people who have these conditions, nearly 5 out of 100 will have a stroke.

A score of 6 ups the risk of stroke to 9.3% – meaning 9 out of 100 people will have a stroke this year.

Atrial Fibrillation in Cardiology (AFib)

Preventing Stroke

If you have atrial fibrillation (AFib), your heart beats irregularly. As a result, your heart has a harder time pumping blood out and to the body. When this happens, blood can pool in the heart and form clots. If a blood clot travels through the bloodstream, it can block a blood vessel in the brain and lead to a stroke.

On average, people with AFib are 5 times more likely to suffer a stroke than those with a normal heartbeat. Strokes related to AFib are often more severe than strokes from other causes.

What does that mean for you or a loved one who has AFib?

When a stroke happens, it tends to be debilitating, often leaving someone fully dependent on others for daily tasks such as dressing, and getting in and out of bed. It might also steal your ability to talk or think clearly.

Stroke is a leading cause of death and disability.

The good news is that blood thinners, also called anticoagulants, can be used to lower the chance of stroke. It is estimated that 3 out of 4 AFib-related strokes can be prevented. This is why health care teams may prescribe a blood thinner for people with AFib.

For people at high risk for stroke due to AFib and who are unable to take blood thinners because of repeated bleeding or a high risk of bleeding, then a left atrial appendage closure device might be considered.

Atrial Fibrillation in Cardiology (AFib)

Treatment of Atrial Fibrillation

The good news is that with the right treatment, you can live a long, healthy life with AFib. But you need to be in tune with your heart and body. If untreated, atrial fibrillation can lead to blood clots, stroke and other heart-related problems, including heart failure. 

Your treatment will likely depend on:

  • Your age
  • Your symptoms and how often the episodes happen
  • Whether your heart rate is under control
  • Your risk for stroke
  • Other medical conditions, including if you have heart disease 

Treatment of AFib focuses on lifestyle changes and either rate control or rhythm control. Therapies to prevent stroke are also important. 

Lifestyle Changes

Lifestyle changes may include:

  • Eating a heart-healthy diet full of fresh fruits and vegetables, fiber-rich foods, lean meats and fish, and unsaturated fats like olive oil
  • Limiting alcohol
  • Exercising regularly – aim to get 30 minutes of physical activity most days
  • Managing stress levels
  • Not smoking
  • Taking your medication(s) as directed and managing other conditions 
  • Treating sleep apnea

In addition to lifestyle changes, treatments often include medications, procedures, or both.


Medications are used to:

  • Prevent clots from forming or to break up an existing clot
  • Restore your heart’s rate or rhythm 
Rate controlling medicationsHeart rhythm controlling medications
Used to slow the heart rate during AFibMay relieve symptoms caused by a fast heart rateExamples include:Beta-blockersCalcium channel blockersDigoxin (brand: Lanoxin)Used to return the heart to its normal rhythm and keep AFib from returningMay relieve symptoms caused by an irregular heart rateExamples include:FlecainidePropafenoneDronedaroneSotalolDofetilideAmiodarone

Medications to prevent or treat blood clots and stroke include blood thinners, also called anticoagulants, for example:

  • Warfarin (brand name: Coumadin, Jantoven)
  • Dabigatran (brand: Pradaxa)
  • Rivaroxaban (brand: Xarelto)
  • Apixaban (brand: Eliquis) 
  • Edoxaban (brand: Savaysa)

Talk with your care team about which blood thinner is right for you. Keep in mind that if you take a blood thinner, you must be very cautious about falls and other accidents that might cause bleeding. There are medicines or antidotes that can reverse the blood-thinning power of warfarin, but those don’t exist yet for the newer medications. 

You might also have limits on what you can eat. For example, foods like spinach, kale and other vegetables are rich in vitamin K, which can disrupt the way warfarin works. That’s why you have to be careful to eat the same amount every day if you take warfarin. You also need to have your blood checked often when taking this medicine (called your INR/PT).  

If you have major bleeding on a blood thinner, your care team may talk with you about a procedure that closes the left atrial appendage – a common location for clots in patients with atrial fibrillation.


Your treatment may also involve medical procedures such as:

  • Cardioversion – low-voltage electrical shock is applied to the chest with paddles to restore a normal rhythm
  • Ablation – a tube is inserted into a vein in the leg and threaded to the heart to fix the faulty electrical signals
  • Surgical maze – small scar lines are made on the heart to create a “maze” that prevents or redirects the abnormal beats from controlling the heart. This is done through open-heart surgery.
  • Pacemaker – an implantable device that prevents your heart rate from beating too slowly. This is used if your medications are causing too slow of a heart rate, or if an ablation is done to prevent your heart rate from going fast.
Atrial Fibrillation in Cardiology (AFib)

Exams and Tests Atrial Fibrillation

Exams and Tests

If you suspect you have atrial fibrillation – or when you first find out you have it – your care team will ask about your symptoms, review your medical history and perform a physical exam. Based on this information, your care team may order other tests to help plan your treatment. These tests include:

  • Electrocardiogram (ECG): Small electrodes are attached to your arms and chest to record electrical signals from your heart. This is the main way AFib is diagnosed.
  • Heart ECG monitor: A heart ECG monitor (examples include a Holter or event monitor) allows for your heart’s electrical activity to be recorded over a longer period of time (hours to weeks). It can show whether you are going in and out of AFib or whether you have a persistent form of AFib.
  • Echocardiogram: A test that uses sound waves from a device called a transducer to image your heart. It can show whether you have a problem with the structure of your heart, such as a weakened heart muscle or heart valve disease. This test can be done non-invasively over your chest. Sometimes using a device that is passed through your throat under sedation is needed to rule out blood clots in the heart.
  • Blood tests: Your care team may order blood tests to check for thyroid or kidney problems.
  • Stress test: Your care team may order a stress test to look for possible blockages in the arteries supplying your heart.
Atrial Fibrillation in Cardiology (AFib)

Signs and Symptoms of Atrial Fibrillation

Some people with AFib don’t have any symptoms. Those who do may report:

  • Heart palpitation – a thumping or racing heart, fluttering or skipping beats
  • Feeling unusually tired or fatigued
  • Unexplained shortness of breath
  • Dizziness or fainting spells
  • Chest pain (angina)

What Increases Your Risk?

Several factors make AFib more likely:

  • Older age, although it can happen at any age
  • Conditions that place added strain on the heart including high blood pressure, a previous heart attack, heart surgery, valve disease, heart failure
  • Other illnesses such as obesity, sleep apnea or hyperthyroidism
  • Family history   
  • Drinking too much alcohol (routinely having 3 or more drinks a day or binge drinking) 

Episodes of AFib are often triggered by certain activities. These may include: 

  • Heavy alcohol use
  • Excessive stimulants such as amphetamines and tobacco
  • Periods of severe stress
    • the stress of the body fighting infection
    • the stress of recent surgery

Pay attention to what might make your symptoms of AFib worse. Be sure to share this information with your health care team.