Understanding Atrial Fibrillation: Symptoms, Risks, and New Hope for Treatment

Jul 21, 2025

Atrial fibrillation (AF or AFib) is the most common sustained heart rhythm disorder. It affects more than 40 million people worldwide, and it becomes more common with age. While AF can be serious, the good news is that treatment options have advanced rapidly in recent years. Patients now have more ways to live well with the condition.

What Is Atrial Fibrillation?

Dr. JoEllyn C. Moore, an electrophysiologist at Allina Health Minneapolis Heart Institute and the Joseph F. Novogratz Family Heart Rhythm Science Center at the Minneapolis Heart Institute Foundation, explains that the heart runs on its own natural electrical system. Just as a house has electrical wiring behind the walls that sends power to different rooms, the heart has pathways that send electrical signals to different chambers to squeeze and pump blood. When that electrical system is working correctly, the heart beats in a steady rhythm.

Atrial fibrillation is like a power surge or short circuit in the system. Instead of sending a single, clear signal, the electrical signals in the heart’s upper chambers (the atria) become chaotic, creating an electrical storm. As these signals spread, they bombard the lower chambers and cause the heart to beat irregularly and often too quickly. AF can lead to a variety of symptoms and health risks.

AF Symptoms Differ

One of the trickiest parts about atrial fibrillation is that everyone experiences it differently. Some people feel nothing at all. Others might notice varying symptoms:

A racing or irregular heartbeat
Fatigue or low energy
Dizziness or lightheadedness
Chest discomfort
Shortness of breath
Sweating
Swelling in the legs
Frequent urination
Fainting

If you’ve experienced any of these symptoms, AF may be the cause.

What Causes AF?

Atrial fibrillation is associated with several risk factors, including:

High blood pressure
Untreated sleep apnea
Heart disease or abnormal heart valves
Diabetes
Heavy alcohol use
Thyroid disorders
Previous heart surgery
Obesity
Family history of AF
Extreme exercise in endurance athletes

How Is AF Diagnosed?

AF is typically diagnosed with an electrocardiogram (EKG), which records the heart’s electrical activity. For people who don’t always feel symptoms, wearable monitors—such as EKG smartwatches or external cardiac patches—can help track irregular episodes and provide valuable data to doctors.

The ABCs of AF Treatment

Treating atrial fibrillation focuses on three major goals:

A – Avoid stroke:
AF increases the risk of stroke due to blood clots that can form in the heart, especially in a small pocket called the left atrial appendage. Blood thinners (examples include apixaban, rivaroxaban, or warfarin) are often prescribed to reduce this risk. If blood thinners aren’t safe for an individual, a basket-like medical device (called the Watchman) can be implanted via a minimally invasive procedure to block off the appendage and prevent clots from escaping.

B – Better symptom control:
Medications can help slow the heart rate and keep its rhythm steady. Cardioversion (a quick electric shock to reset the heartbeat) or ablation (a procedure to isolate the source of the rhythm problem) may also be recommended.

C – Comorbidities (risk factor management):
Treating conditions like high blood pressure, sleep apnea, and diabetes is crucial to managing AF and reducing complications.

Ablation: A Game-Changer in AF Treatment

Because cases of AF start with electrical misfires in the veins that carry blood from the lungs to the heart, catheter ablation treats the condition by targeting these misfires. A minimally invasive procedure creates small scars around the pulmonary veins to block the erratic signals from spreading.

There are several types of ablation:

Radiofrequency ablation: Uses heat to create scar tissue
Cryoablation: Freezes tissue
Pulse field ablation: Uses electric fields to destroy cells in a more targeted way – this newer approach reduces damage to surrounding structures

Ablation procedures are guided by advanced imaging like ultrasound, X-rays, and 3D mapping, and are performed by threading a catheter up through a vein in the leg to reach the heart. While ablation is not a cure, it significantly improves symptoms and quality of life for many.

After the procedure, some patients require medication to control symptoms and others require repeat ablations. Lifelong AF care and monitoring is still needed; however, as technology advances continue, doctors hope to see longer-lasting results.

Living with AF

AF is a lifelong condition, but it doesn’t mean giving up loved activities. Thanks to new technology, doctors have more tools than ever to help people feel better and stay active. Additional research is ongoing to continually advance these treatments.

Most importantly, you are not alone. If you or a loved one is living with atrial fibrillation, talk to your doctor. Together, you can find the right path to manage your symptoms, lower your risks and improve your quality of life.