Atrial Fibrillation Living With

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If you have been diagnosed with atrial fibrillation, it is important that you continue your treatment. With follow-up care your healthcare provider can check your condition, talk to you about how to prevent repeat events, and give you instructions about what to do in an emergency. Sometimes, atrial fibrillation returns to a normal heart rhythm without treatment.

If undetected or untreated, atrial fibrillation can lead to serious complications. This is an especially important point for people who are Black or African American. Even though white Americans have atrial fibrillation at higher rates, research has found that many of the complications — including stroke, heart disease, and heart failure — are more common for Black and African-American people.

See more information about serious complications in the list below.

• Blood clots can happen when atrial fibrillation keeps the heart from pumping the blood out properly. When this occurs, the blood pools and can form an abnormal blood clot in the heart. A piece of the clot can break off and travel through the blood to other parts of the body, blocking blood flow to organs such as the brain, lungs, intestines, spleen, or kidneys. Atrial fibrillation may also increase the risk of venous thromboembolism, a blood clot that forms in a vein.
• Cognitive impairment and dementia, including Alzheimer’s disease and vascular dementia, occur more often among people with atrial fibrillation, according to some research studies. This may be due to blockages in the blood vessels of the brain or reduced blood flow to the brain.
• Heart failure risk is higher if you have atrial fibrillation because the heart is beating quickly and unevenly. The heart’s chambers do not fill completely with blood and cannot pump enough blood to the lungs and body. Atrial fibrillation may also make existing heart failure symptoms worse.
• Stroke may occur if a blood clot travels to and blocks a blood vessel that supplies the brain. For some people, atrial fibrillation has no symptoms, and a stroke may be the first sign of the condition. If you are a woman who has atrial fibrillation, the risk of a stroke is higher.
• Cardiac arrest (when the heart suddenly and unexpectedly stops beating) is very rare but may be more likely to occur if you have atrial fibrillation and another serious heart condition.

How often you need to visit your provider for follow-up care will depend on your symptoms and treatment. Be sure to attend all of your follow-up appointments as recommended by your healthcare provider. You can make these visits, and any other visits with a provider, more efficient and productive by taking these steps:

• Bring a list of all the medicines you are taking. Do this for every provider and emergency room visit. This will help any healthcare provider know exactly what medicines you are taking.

• Take your medicines as prescribed. If you are taking medicines to treat atrial fibrillation, your provider will check the dose of the medicines as well as their effects on your body’s electrolyte levels and how they affect other organs.
• Tell your provider if your medicines are causing side effects, if your symptoms are getting worse, or if you have new symptoms.
• Ask your provider about recommended physical activity levels, weight control, and alcohol use. 
• If you use illegal or street drugs, ask your provider how to get help to stop. You can also call the Substance Abuse and Mental Health Services Administration’s National Helpline at 1-800-662-HELP.
• Check with your provider before taking over-the-counter medicines, nutritional supplements, or cold and allergy medicines. Some of these products can trigger rapid heart rhythms or interact poorly with other medicines you may be taking. In addition, medicines to treat arrhythmia can make the effect of blood thinners stronger.
• If you have had an ablation, your provider may want to see you regularly to check on the healing process and any new or additional atrial fibrillation episodes, and to adjust blood thinning medicines as needed. You will continue to take blood thinners for several months and maybe much longer. Report any lasting pain — for example, at the site of an incision — or any other signs of a complication. Your provider may also want to see you at least once a year after the initial follow-up period.
• If you are taking a blood thinning medicine, talk to your provider about any other instructions you need to follow.
  • You may need to avoid certain other medicines and watch what you eat.
  • If you are taking a blood thinner and need a dental or medical procedure, you will need to talk to your doctor first to see if you need to temporarily hold or adjust your blood thinner dose or schedule.
  • Blood thinners called DOACs may only need to be monitored on your own at home.
  • For blood thinners like warfarin, your provider will do blood tests every week at first, then monthly once the level has stabilized.

Regular visits to the clinic give your provider a chance to learn how well medicines are controlling your atrial fibrillation, keep track of your ongoing risks of clotting or bleeding, and check how well you are healing from any procedures.

• Blood tests check the effects of certain heart rhythm medicines on your thyroid, kidneys, or liver. The blood thinner warfarin also requires regular testing to make sure the dose is correct. In some cases, your provider may talk to you about devices available to monitor your blood thinning medicines at home. Blood thinners may be stopped or adjusted if you are going to have surgery.
• Electrocardiogram (EKG) monitoring can help detect a repeat atrial fibrillation event or assess your response to medicine and dose changes. You may record an EKG during your regular visits, or you may wear a portable monitor, sometimes called Holter or event monitor.
• Stress tests or a six-minute walking test can help your provider learn whether your medicine prevents atrial fibrillation while you are doing typical everyday activities.

To help prevent a repeat episode of atrial fibrillation, your provider may recommend some specific actions.

• Make heart-healthy lifestyle changes, including aiming for a healthy weight. Combining weight loss with physical activity and managing other risk factors such as high blood pressure, diabetes, alcohol use, and smoking can improve symptoms more than weight loss alone.
• Take medicine at home as needed to correct your heart rhythm. Before giving you medicine, your provider will ask you to take a dose then try to trigger an event to see if the medicine works to prevent the event. Your provider can then determine how much medicine you need to manage your condition.
• Treat your underlying condition, such as sleep apnea, high blood pressure, or diabetes.

Atrial fibrillation can lead to serious complications, especially if it is untreated or undiagnosed. There are also some risks of treatment with blood thinners, including the possibility of severe bleeding in the brain.

If you see any signs or symptoms of the following conditions in yourself or someone else, call 9-1-1 right away.

• If you think you recognize the signs of a stroke, such as sudden weakness, sudden trouble speaking, walking, or seeing, or sudden headache, call 9-1-1 immediately. Every minute matters.
• Bleeding in the brain, digestive system, or urinary tract can occur if you take a dose of blood-thinning medicines that is too high. Symptoms may include bright red vomit; bright red blood in your stool or black, tarry stools; blood in your urine; severe pain in the abdomen or head; sudden, severe changes in your vision or ability to move your arms or legs; or memory loss.
• Excessive bleeding after a fall or injury or easy bruising or bleeding may mean that your blood is too thin. Excessive bleeding is bleeding that will not stop after you apply pressure to a wound for 10 minutes.
• A heart attack causes symptoms such as mild or severe chest pain or discomfort in the center of the chest or upper abdomen that lasts for more than a few minutes or goes away and comes back. It can feel like pressure, squeezing, fullness, heartburn, or indigestion. There may also be pain down the left arm. Women may have chest pain and pain down the left arm, but they are more likely to have less typical symptoms, such as shortness of breath, nausea, vomiting, unusual tiredness, and pain in the back, shoulders, or jaw.
• Cardiac arrest is a possible explanation if someone suddenly faints. At the same time, there will be no heartbeat. Just before they faint, some people may have a racing heartbeat or feel dizzy or light-headed. Within an hour before cardiac arrest, some people have chest pain, shortness of breath, nausea, or vomiting. Call 9-1-1 right away if someone has symptoms of cardiac arrest. Look for a defibrillator nearby and follow the instructions.