Atrial fibrillation (heart flutter)
Atrial fibrillation (also commonly referred to as AFib) is the most widespread persistent heart rhythm disorder observed in adults. During atrial fibrillation, the electrical signals coordinating the heart's upper chambers (the atria) become highly disorganized, causing the heart to beat rapidly and irregularly.
While some individuals experience distinct symptoms—such as palpitations, shortness of breath, sudden fatigue, or a noticeable decline in physical stamina—others present with no symptoms at all.
Although AFib is rarely immediately life-threatening on its own, it requires prompt clinical evaluation and management. Left untreated, the condition significantly elevates the long-term risk of cardiovascular complications, most notably ischemic stroke.
What is atrial fibrillation?
Atrial fibrillation is a rhythm disorder in which the heart's normal electrical activity in the atria is replaced by many rapid and uncoordinated impulses. This means that the heart no longer beats with the regular rhythm seen in people with normal sinus rhythm.
The rhythm disturbance can be short-lived and come in fits or be persistent. The incidence increases with age, and atrial fibrillation is seen more frequently in people with high blood pressure, heart disease, diabetes, obesity or sleep apnea.
Symptoms of atrial fibrillation
Symptoms vary considerably from person to person. Some people immediately notice that their heart is beating irregularly, while others are only diagnosed during a routine examination.
Typical symptoms may include palpitations, rapid pulse, irregular heartbeat, decreased fitness, fatigue, dizziness or shortness of breath during physical activity. In some people, the symptoms may be more pronounced and significantly affect daily life.
The severity of symptoms does not always reflect the extent of the disease. Even people without any symptoms can have atrial fibrillation.
What does atrial fibrillation feel like?
Many people describe atrial fibrillation as a fluttering in the chest or a feeling that their heart is beating fast, irregularly, or skipping beats. Others experience decreased energy, shortness of breath, or a marked deterioration in their fitness. Some have no symptoms and are only diagnosed during a routine check-up or when an irregular pulse is noted.
How do the symptoms vary?
Many people describe atrial fibrillation as a fluttering in the chest or a feeling that the heart is beating fast, irregularly, or skipping beats. Others experience a sudden change in heart rate and performance, especially during physical activity.
Some only notice the rhythm disturbance for short periods, while others experience persistent symptoms. There are also patients who have no noticeable symptoms despite atrial fibrillation.
Causes of atrial fibrillation
Atrial fibrillation can occur for many different reasons. The risk increases with age, but a number of diseases and conditions can also contribute to its development.
High blood pressure is one of the most common risk factors. In addition, atrial fibrillation is more common in people with heart failure, valvular heart disease, ischemic heart disease, diabetes, sleep apnea, or obesity.
In some people, heavy alcohol consumption, infections, or other stresses on the body can trigger episodes of atrial fibrillation. In other cases, there is no obvious explanation.
How is the diagnosis made?
The diagnosis is made by recording the heart's electrical activity on an ECG. If the rhythm disturbance only occurs intermittently, longer-term recording with Holter monitoring or event recorder may be necessary.
If atrial fibrillation is suspected, the structure and function of the heart will often be examined with echocardiography. In addition, blood tests and assessment of any accompanying diseases may be part of the investigation.
The purpose is both to confirm the diagnosis and to identify possible causes or risk factors.
Treatment of atrial fibrillation
Treatment depends on, among other things, the extent of the symptoms, the patient's age, any concomitant diseases, and the risk of complications.
For some, the primary goal is to control the heart rate and reduce symptoms. For others, it may be relevant to try to restore normal heart rhythm with medical treatment or other forms of therapy.
An important part of the assessment is also the risk of blood clots. Atrial fibrillation can increase the risk of blood clots in the brain, and some patients will therefore need blood-thinning treatment.
The specific treatment is always tailored to the individual patient.
Is atrial fibrillation dangerous?
Atrial fibrillation is rarely life-threatening in itself, but the condition may be associated with an increased risk of complications, especially blood clots in the brain.
The risk varies considerably from person to person and depends on factors such as age, comorbidities and other risk factors. Therefore, it is important to assess both the rhythm disturbance and the overall cardiovascular risk.
With proper diagnosis and treatment, many people can live an active life with atrial fibrillation.
When should you seek a cardiologist?
It may be relevant to be examined by a cardiologist if you experience persistent or recurring palpitations, irregular heartbeat, unexplained fatigue, dizziness, or decreased physical performance.
This also applies if an activity tracker or smartwatch repeatedly detects irregular heartbeats.
Frequently Asked Questions
Is *atrieflimren* the same as *hjerteflimmer*?
Yes. *Atrieflimren* (atrial fibrillation) and the more common term *hjerteflimmer* are different names for the same common heart rhythm disorder.
Can atrial fibrillation go away on its own?
Yes. In some people, atrial fibrillation occurs in attacks that stop spontaneously. In others, the rhythm disturbance becomes more persistent over time.
Can you live with atrial fibrillation?
Many people live active lives with atrial fibrillation. Treatment and follow-up are tailored to the individual patient's situation and risk profile.
Is atrial fibrillation dangerous?
Atrial fibrillation can increase the risk of blood clots and other complications, but the risk varies significantly from person to person.
Can stress trigger atrial fibrillation?
Stress is rarely the direct cause, but physical or mental stress can contribute to triggering symptoms or episodes in some people.
Can alcohol trigger atrial fibrillation?
In some patients, higher alcohol intake may increase the risk of atrial fibrillation episodes.
My smartwatch shows an irregular heartbeat – what does it mean?
Many modern smartwatches can detect signs of irregular heartbeat. Such detection is not in itself a diagnosis, but may prompt further investigation with an ECG or long-term rhythm recording.