Could it be A-fib? Signs of an irregular heart rhythm

Your heart can speed up or slow down for plenty of normal reasons. But if it suddenly feels like it’s fluttering, racing or beating out of rhythm, it may be worth paying attention.

Atrial fibrillation, or A-fib, is a common type of irregular heart rhythm, or arrhythmia. During A-fib, abnormal electrical signals cause the heart’s upper chambers, called the atria, to beat irregularly instead of following their usual steady rhythm.

When this happens, blood can pool in the atria and form clots. If a clot travels to the brain, it can cause a stroke. Recognizing A-fib and getting the right treatment can help manage symptoms and reduce your risk of complications.

What A-fib can feel like

A fluttering, quivering or racing feeling in your chest is a common sign of A-fib.

“We’re usually not aware of our heart beating,” says Supreeya Swarup, D.O., an interventional cardiologist with Sutter. “But if you pay attention and notice that it’s beating erratically or beating irregularly, that could be A-fib.”

Some people notice only a rapid or irregular heartbeat. Others may experience symptoms such as:

• Confusion
• Dizziness or lightheadedness
• Fatigue
• Feeling faint
• Shortness of breath
• Sweating
• Weakness

Some people with A-fib don’t have any symptoms at all.

Chest pain or pressure can be a medical emergency. If you experience it, call 911 right away.

Who is at risk for A-fib?

Your risk of developing A-fib increases as you get older. A-fib can also run in families. Other factors that can increase your risk of A-fib include:

• Alcohol use
• High blood pressure
• Obesity
• Other chronic conditions, such as Type 2 diabetes, asthma, hyperthyroidism and chronic kidney disease
• Physical inactivity
• Sleep apnea
• Smoking
• Underlying heart disease

Some risk factors, such as age and family history, are outside your control. But staying active, not smoking, limiting alcohol and managing health conditions such as high blood pressure can help support your heart health.

How A-fib is diagnosed

Your doctor will ask about your symptoms and medical history and perform a physical exam. You may also have blood tests to look for health conditions that could contribute to an irregular heart rhythm.

An electrocardiogram, or EKG, records your heart’s electrical activity and can detect A-fib if the irregular rhythm is happening during the test.

“If they catch it on the EKG, then there you go,” Swarup says. “You have your diagnosis.”

Because A-fib can come and go, a short EKG may not always capture it. If your heart rhythm is normal during the test, your doctor may recommend wearing a portable heart monitor for 24 to 48 hours or longer. The monitor records your heart rhythm over time and can help detect episodes that happen intermittently.

How A-fib is treated

A-fib can affect people differently. For some, episodes may become more frequent or last longer over time. Treatment can help control symptoms, manage your heart rhythm and reduce your risk of complications.

Your doctor will consider factors such as your symptoms, stroke risk, overall health and how long you’ve had A-fib when recommending treatment.

Depending on your needs, treatment may include medication to reduce your risk of blood clots or control your heart rate or rhythm. Some people may also benefit from a procedure such as cardioversion, which uses medication or an electrical shock to help restore a normal heart rhythm.

Catheter ablation may be another option for some people. Your doctor can help you understand which approach makes sense for you and how your treatment may change over time.

When to call your doctor

A-fib can come and go. You might notice an unusual heartbeat for a few minutes and then feel normal again. Even if the sensation goes away, it’s worth telling your doctor about a new or unusual change in your heart rhythm.

“If you feel something that is not a usual pattern for you, you should definitely call your physician,” Swarup says. “Anything that’s out of the ordinary should mean a call to your physician.”

Because some people with A-fib don’t have noticeable symptoms, you may also want to talk with your doctor about your risk, particularly as you get older or if you have health conditions associated with A-fib.

“Definitely ask any questions that you have,” Swarup says. “That’s really vital.”