Dr. John Day, Cardiologist

The 12 Most Common Atrial Fibrillation Symptoms

Most of our patients mistakenly believe they don’t have any AFib symptoms because they can’t feel the palpitations that are commonly associated with this arrhythmia. While many patients do indeed experience palpitations, in my experience most do not. In this article we’ll cover the 12 most common AFib symptoms and how to get rid of them once and for all. Read on to learn more…

The Top 3 AFib Symptoms

Sadly, most AFib patients don’t experience palpitations. If you’re not sure what “palpitations” are, many of my patients describe it as if there is a fish flopping around in their heart.

In fact, I put palpitations as the third most common symptom associated with AFib. If everyone felt palpitations with AFib, patients would be alerted to the second AFib started which would lead to a much earlier diagnosis, quicker treatment, and a much better chance of avoiding the long-term complications from AFib.

With palpitations solidly in the number 3 position, the very most common AFib symptom I see is fatigue followed by shortness of breath or getting winded easily with exertion.

It can, of course, be hard to pin feelings of being fatigued and breathless to one specific problem. Fatigue and shortness of breath can be side-effects of many medications. They can also result from not exercising regularly, being overweight or not sleeping well.

But if you’re feeling tired and breathless, and you can’t figure out why, you need to find out why. Lara, one of my patients we discussed in our best-selling book, The AFib Cure, didn’t do that, at first. “I’ve skied my whole life,” she recalled. “Suddenly I couldn’t anymore. I was always so tired—the way I used to feel after a race, except I wasn’t racing.”

That is likely because Lara’s heart was beating much faster than normal and her body was struggling to keep up. It takes a lot of energy to keep a heart on overdrive, the same sort of energy it takes to engage in a heavy workout. But, like many people, Lara at first chalked up these symptoms as the consequences of “getting too old.” (Which is why, when we help our patients get their hearts back into normal rhythm again, they often remark how much younger they feel.)

The 4th, 5th, and 6th Most Common AFib Symptoms

Lightheadedness, dizziness and confusion are also very common symptoms of atrial fibrillation. “Brain fog,” the feeling of not being able to think clearly, is another common symptom. And, again, once you understand what AFib does inside the body, these symptoms make perfect sense. Our brains are ravenous for oxygen, after all, and oxygen moves through our bodies via our circulatory system. In a healthy human body, this system is perfectly designed to deliver oxygen exactly where it is needed, when it is needed. But when the organ at the center of this closed system is malfunctioning, the entire system begins to falter. The oxygen molecules being transported by hemoglobin, a protein carried throughout our bodies by our red blood cells, may still arrive, but not at the same, steady rate our brains are used to.

All of this helps explain why we, as well as other researchers, are coming to discover a long-term consequence of atrial fibrillation that is terrifying to a lot of people: brain damage. Our research team has discovered that many of the chemical signs of brain injury that are elevated after a concussion—like glial fibrillary acidic protein, stress response marker growth/differentiation factor 15, and tau protein—are chronically high in atrial fibrillation patients. These proteins, which typically are elevated in response to an injury to the brain and its barrier from the rest of the body, are released very early in people who have atrial fibrillation, a reflection of the chronic insult of the abnormal heart rhythm on the brain.

It’s not just molecules swimming around in our body that testify to the damage being done to our brains. When you use an MRI to look at the brains of people with AFib, nearly half have visible signs of brain damage in the form of brain lesions, even if they’ve never suffered from a stroke. Those who do not have brain lesions consistent with stroke often have volume loss, also known as “brain shrinkage,” and small patterns of brain injury called “white matter disease.” These changes reflect damage done to the brain both from atrial fibrillation and other medical problems, like hypertension and diabetes, that may have caused the AFib.

This might help explain why the rate of dementia is so much higher among people with atrial fibrillation. We’ve known for nearly half a century that lesions are more common in the autopsied brains of people who suffered from dementia at the end of their lives, but it hasn’t always been clear where these lesions came from. More recently, our research has shown that atrial fibrillation is independently associated with all forms of dementia, including Alzheimer’s disease. Not surprisingly, our ground-breaking research showed that the presence of AFib was a strong predictor of which dementia patients are at highest risk of death. Also, and quite disconcertingly, these findings suggested that the risk of Alzheimer’s, in particular, was increased even among younger AFib patients.

Other AFib Symptoms (Top AFib Symptoms 7-12)

7. Chest pain

Chest discomfort is always a scary symptom for AFib patients. How do you know if it is a life-threatening heart attack or just your AFib acting up again? While this may require a trip or two to the emergency room and a few visits with your cardiac electrophysiologist to figure out, in general, if the chest discomfort starts the exact second you go into AFib and then stops the very same second your AFib stops then there is a pretty good chance it is just the AFib.

8. Fainting

Fainting from AFib happens from a lack of blood flow to the brain. This can be from either the heart beating so fast in AFib or from the heart stopping for a few seconds when the AFib stops.

9. Anxiety

There is something very unsettling about AFib. And even for patients who don’t feel palpitations, there is a sense of generalized anxiety that happens when their hearts are out of rhythm and then goes away when normal sinus rhythm returns.

10. Sweaty

Over the years many of my patients have reported feeling sweaty, excessive sweating, or feeling “clammy” when their heart is doing its AFib thing.

11. Weakness

For many of my older patients, the only AFib symptom they experience is just generalized weakness while they are in AFib. Some older patients even report they have trouble getting out of bed or out of a chair when they are in AFib.

12. Urination

Surprisingly, many of my patients know they are in AFib because in the early stages of an AFib attack they have to keep running to the bathroom to urinate. What causes frequent urination in the early part of an AFib attack? A fibrillating atrium releases the hormone atrial natriuretic peptide (ANP) which causes the kidneys to quickly dump urine.

How to Make AFIb Symptoms Go Away

Based on my experience of having treated tens of thousands of AFib patients over the last 30+ years, most of my patients are suffering from at least one of the 12 symptoms covered in this article. And if you are like most of my patients, you probably want to get rid of these symptoms. The key to beating AFib, as we described in our book The AFib Cure, is as follows:

1. Get your AFib diagnosed and treated as fast as possible.

2. If you have AFib triggers, such as alcohol, stress, sleep deprivation, etc. avoid these triggers.

3. Live as healthy as you possibly can by optimizing your nutrition to maintain a healthy body weight, exercise every day, get enough rejuvenating sleep every night, and keep stress levels down.

4. If avoiding triggers and living as healthy as you possibly can doesn’t put your AFib into remission, consider an ablation.

5. Always track your health and maintain a lifelong commitment to healthy living.

If you liked the photo attached to this article it was taken from my favorite chairlift, the 9990 chairlift at Park City Mountain Resort.