Majority of patients will not present with any symptoms at all. Only mild palpitations, chest discomfort, light headedness, dyspnea, and generalized weakness are subjectively felt by the patients. Upon physical examinations, pulses and auscultatory findings will reveal an irregularly regular rhythm. Pulses may not coincide with ventricular rates because the pumping may not generate sufficient blood or force to produce peripheral pressure.

• Weakness

  Protective factors were a history of diabetes mellitus (weak association) and the presence of a urinary tract infection (weak association). [ncbi.nlm.nih.gov]

  This usually presents as palpitations, dyspnea, dizziness, fatigue, and weakness among afflicted patients. The irregular atrial rhythm in atrial fibrillation raises the risk for embolic stroke among susceptible patients. [symptoma.com]

  But you may feel Palpitations -- an abnormal rapid heartbeat Shortness of breath Weakness or difficulty exercising Chest pain Dizziness or fainting Fatigue Confusion AF can lead to an increased risk of stroke. [medlineplus.gov]

  Certain abnormalities seen on an ECG can also suggest bulges (aneurysms) that develop in weak areas of the heart's walls. Aneurysms may result from a heart attack. [merckmanuals.com]

• Fatigue

  Symptoms include irregular pulse, palpitations, shortness of breath and fatigue. Inova offers leading expertise in all aspects of atrial fibrillation management. [inovaheart.org]

  But you may feel Palpitations -- an abnormal rapid heartbeat Shortness of breath Weakness or difficulty exercising Chest pain Dizziness or fainting Fatigue Confusion AF can lead to an increased risk of stroke. [medlineplus.gov]

  Treating AF may prevent stroke, fatigue, and heart failure. Find a specialist who can determine if your symptoms are a result of atrial fibrillation. Causes The causes of AF are often unclear. [medtronic.com]

• Collapse

  In 1990 the American college football player Hank Gathers suddenly collapsed and died during a televised intercollegiate basketball game.[42] He had previously collapsed during a game a few months prior. [en.wikipedia.org]

  Flecainide is contraindicated in patients with left ventricular dysfunction or coronary artery disease due to the risk of ventricular arrhythmias. 30 As it may also facilitate transition of AF to atrial flutter with 1 : 1 conduction, leading to haemodynamic collapse [doi.org]

  Others may present with stroke, overt heart failure, or cardiovascular collapse. Patients most commonly report palpitations, dyspnea, fatigue, lightheadedness, and chest pain. [web.archive.org]

• Malaise

  If symptoms occur, they may include: sensations of a ‘fluttering’ heartbeat (palpitations) irregular heartbeat (detected by checking the pulse) angina (chest pains) general malaise dizziness inability to tolerate exercise fainting spells. [betterhealth.vic.gov.au]

  Reduce dose with hepatic impairment and start with smaller dose in renal impairment. 90-360 mg QD (ER)  Verapamil 0.075-0.15 mg/kg IV bolus over 2 minutes, then 5 mcg/kg/min 40-120 mg TID Dizziness, malaise, lethargy, headache, hot flushes, gastrointestinal [ekjm.org]

• Pathologist

  All measurements were performed in a Clinical Laboratory Improvement Amendments–certified laboratory accredited by the College of American Pathologists. [dx.doi.org]

• Dyspnea

  This usually presents as palpitations, dyspnea, dizziness, fatigue, and weakness among afflicted patients. The irregular atrial rhythm in atrial fibrillation raises the risk for embolic stroke among susceptible patients. [symptoma.com]

  Shortness of breath Other names Dyspnea, dyspnoea, breathlessness, difficulty of breathing, respiratory distress Pronunciation Dyspnea: /dɪspˈniːə/ Specialty Pulmonology Shortness of breath (SOB), also known as dyspnea, is a feeling of not being able [en.wikipedia.org]

  He developed pronounced dyspnea on exertion, and repeated ECGs and another Holter monitor now showed persistent AF. [doi.org]

  Symptoms include palpitations and sometimes weakness, effort intolerance, dyspnea, and presyncope. Atrial thrombi may form, causing a significant risk of embolic stroke. Diagnosis is by electrocardiography. [merckmanuals.com]

• Exertional Dyspnea

  Distinct sensations include effort/work, chest tightness, and air hunger (the feeling of not enough oxygen).[1] Dyspnea is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations[2] or light exertion. [en.wikipedia.org]

• Nausea

  We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. [ncbi.nlm.nih.gov]

  While taking anticoagulants, make sure the doctor knows about any planned or existing pregnancy or any signs of bleeding, such as: very large bruises nausea and light-headedness vomiting blood coughing up blood unusually heavy menstrual flow gums that [medicalnewstoday.com]

  […] duration, and spontaneous recovery.[1] It is caused by a decrease in blood flow to the brain, typically from low blood pressure.[1] There are sometimes symptoms before the loss of consciousness such as lightheadedness, sweating, pale skin, blurred vision, nausea [en.wikipedia.org]

  Medications may include: Dofetilide Flecainide Propafenone Amiodarone Sotalol Although these drugs may help maintain a normal heart rhythm, they can cause side effects, including: Nausea Dizziness Fatigue Rarely, they may cause ventricular arrhythmias [mayoclinic.org]

• Heart Disease

  Arial fibrillation is strongly associated with cardiovascular diseases like coronary artery diseases (CAD), congestive heart failure (CHF) and diabetes mellitus. [symptoma.com]

  Atrial fibrillation is not a single disease. It can have different causes. The cause will affect which treatments are used. Afib is associated with congestive heart failure, structural heart disease, and heart valve problems. [inovaheart.org]

  The most common causes of AF are coronary heart disease, hypertension, valvular heart disease and hyperthyroidism. [patient.info]

  There is no one “cause” of atrial fibrillation, although it is associated with many conditions, including: Most common causes After heart surgery Cardiomyopathy Chronic lung disease Congenital heart disease Coronary artery disease Heart failure Heart [my.clevelandclinic.org]

• Palpitations

  This usually presents as palpitations, dyspnea, dizziness, fatigue, and weakness among afflicted patients. The irregular atrial rhythm in atrial fibrillation raises the risk for embolic stroke among susceptible patients. [symptoma.com]

  He correlated gross irregularities (palpitation) with necropsy observation of mitral valve disease and dilatation of the left ventricle. [ncbi.nlm.nih.gov]

  But you may feel Palpitations -- an abnormal rapid heartbeat Shortness of breath Weakness or difficulty exercising Chest pain Dizziness or fainting Fatigue Confusion AF can lead to an increased risk of stroke. [medlineplus.gov]

  He describes the feeling as "tightness," and also reports weakness and palpitations for the past hour. He denies shortness of breath, diaphoresis, or lightheadedness. [medbullets.com]

• Tachycardia

  In the emergency department, atrial fibrillation persisted and he experienced additional episodes of ventricular tachycardia. [ncbi.nlm.nih.gov]

  There are three major types of tachycardia: Atrial tachycardia (starting in the atria) Supraventricular tachycardia (starting above the ventricles) Ventricular tachycardia (starting in the ventricles) Bradycardia refers to a slow heart rhythm, caused [columbiasurgery.org]

  Tachycardias[edit] In adults and children over 15, resting heart rate faster than 100 beats per minute is labelled tachycardia. Tachycardia may result in palpitation; however, tachycardia is not necessarily an arrhythmia. [en.wikipedia.org]

  Instead of intermittently contracting, the atria quiver continuously in a chaotic pattern, causing a totally irregular, often tachycardia ventricular rate. [icd9data.com]

• Chest Pain

  In many patients, it can also cause chest pain, heart attack, or heart failure. [medlineplus.gov]

  If you already have chest pains (angina), the chest pains may become worse if you have AF. AF can also reduce the amount of exercise you're able to do. [patient.info]

  If you have had symptoms and experience chest pain, call 911 immediately. This could indicate you are having a heart attack. [bidmc.org]

  Higher rates cause unpleasant awareness of heart beats ( palpitations ) or chest pain. In people with atrial fibrillation, the pulse is usually rapid and is always irregular. [merckmanuals.com]

• Vascular Disease

  Obesity-related risk factors, such as hypertension, vascular disease, obstructive sleep apnea and pericardial fat, are thought to result in atrial electro-structural dysfunction. [ncbi.nlm.nih.gov]

  This study assesses an online program for people 65 and older who have some combination of diabetes, high blood pressure, high blood cholesterol, COPD, obesity, congestive heart failure, chronic kidney disease, arrhythmia, pulmonary heart or vascular [nhlbi.nih.gov]

  In contrast to the CHADS 2 -Score, additional points for eventual vascular diseases and female gender are given. Moreover, a more exact differentiation of the age is possible: from 65 years on, one point is given, and from 75 years on another point. [flexikon.doccheck.com]

  Anticoagulation is especially important if you have atrial fibrillation and you are a woman, are aged 65 years or older, or have a history of congestive heart failure, high blood pressure, stroke or transient ischemic attack, vascular disease, or diabetes [jamanetwork.com]

• Stroke

  Prevent clot formation (strokes): Stroke is a devastating complication of atrial fibrillation. Blood clots can form in the atria when their motility is impaired as in AFib. [emedicinehealth.com]

  Emboli in the brain may result in an ischemic stroke or a transient ischemic attack (TIA). [en.wikipedia.org]

  Atrial fibrillation is a major risk factor for ischemic stroke, increasing risk of stroke by as much as 5-fold. [ncbi.nlm.nih.gov]

  The decrease in the rate of all stroke was due to a large decrease in ischemic stroke with only a small absolute increase in hemorrhagic stroke. Of all ischemic strokes, 12.5% were lethal. [dx.doi.org]

• Dizziness

  But you may feel Palpitations -- an abnormal rapid heartbeat Shortness of breath Weakness or difficulty exercising Chest pain Dizziness or fainting Fatigue Confusion AF can lead to an increased risk of stroke. [medlineplus.gov]

  This usually presents as palpitations, dyspnea, dizziness, fatigue, and weakness among afflicted patients. The irregular atrial rhythm in atrial fibrillation raises the risk for embolic stroke among susceptible patients. [symptoma.com]

  We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. [ncbi.nlm.nih.gov]

  When symptoms do occur, there may be palpitations (awareness of a rapid heartbeat), fainting, dizziness, weakness, shortness of breath and angina pectoris (chest pain caused by a reduced blood supply to the heart muscle). [hopkinsmedicine.org]

  This can cause problems including dizziness, shortness of breath and tiredness. [nhs.uk]

• Confusion

  But you may feel Palpitations -- an abnormal rapid heartbeat Shortness of breath Weakness or difficulty exercising Chest pain Dizziness or fainting Fatigue Confusion AF can lead to an increased risk of stroke. [medlineplus.gov]

  Heart palpitations Lack of energy Lightheadedness Confusion Chest discomfort Shortness of breath, even at rest Yes. When it becomes constant, you may need treatment. [lifelinescreening.com]

  But you may feel palpitations -- an abnormal rapid heartbeat shortness of breath weakness or difficulty exercising chest pain dizziness or fainting fatigue confusion af can lead to an increased risk of stroke. [icd9data.com]

  However, those with symptoms may experience: Palpitations, or feelings of a rapid, uncomfortable, irregular heartbeat or a flopping in your chest Low blood pressure Weakness Shortness of breath Chest pain Lightheadedness Confusion Fatigue If you have [bidmc.org]

  Others experience: Palpitations: uncomfortable feeling that the heart is racing, beating irregularly or fluttering Fatigue Dizziness Shortness of breath Weakness Lightheadedness Confusion Problems exercising Sweating Chest pain or pressure (a medical [umm.edu]

• Somnolence

  We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. [ncbi.nlm.nih.gov]

Atrial fibrillations are effectively diagnosed by an accurate medical history and a thorough physical examination. The following diagnostic methods and tests may be implored in patients presenting signs and symptoms of atrial fibrillations:

• Electrocardiogram (ECG) is considered the primary tool in diagnosing atrial fibrillations. 
• Holter monitor monitors a 24 hour period of cardiac electrical activity to detect intermittent AF cases.
• Event recorder will record cardiac activities in a period of weeks to months. It comes with an access button that the patient could easily press during an event or period of chest discomfort or irregularity for real time recording of the dysrhythmia. 
• Echocardiography elucidates the heart structures and clot formations during atrial fibrillation events [9].
• Blood tests will determine the presence of electrolyte imbalance and hormonal hyperactivity like hyperthyroidism that can cause clinical dysrhythmias like AF.
• Chest radiography will demonstrate other anatomic pathology of the heart, pericardium, and the lungs that may induce atrial fibrillation.

• Narrow QRS Complex

  On an ECG (EKG), atrial fibrillation is characterized by absence of P-waves and irregular narrow QRS complexes. Reminder: P-wave represents electrical activity of the SA node that is now obscured by activities of multiple ectopic sites. [youtube.com]

• Atrioventricular Dissociation

  After establishment of a stable perfused-heart preparation, the posterior atria were cut away to expose the left and right atrial endocardium, and the atrioventricular node was mechanically crushed, resulting in atrioventricular dissociation. [dx.doi.org]

• Absent A-Waves

  P waves if arrhythmia is not captured on ECG then Holter monitoring in the outpatient setting these patients are hemodynamically stable telemitry in the inpatient setting Transthoracic echocardiogram (TTE) can assess atrial size and ventricular function [medbullets.com]

• Abnormal ECG

  At the same time, the harms of diagnostic follow-up and treatment prompted by abnormal ECG results are well established and include misdiagnosis and invasive testing. [ncbi.nlm.nih.gov]

  But the paper notes that abnormal ECGs were sent to a cardiologist for review, and also says that the Kardia produced some false positives (indications of AFib that the reviewing cardiologists found to be false). [spectrum.ieee.org]

  The performance of ECG itself is not associated with significant harm, although abnormal results may cause anxiety. Misinterpretation of ECG results may lead to misdiagnosis and unnecessary treatment. [doi.org]

  and a wide QRS with a slurred upstroke.[31] Signs of ARVD/C include T wave inversion and epsilon waves in lead V1 to V3.[31] It is estimated that from 20%-50% of people have an abnormal ECG. [en.wikipedia.org]

The general treatment goals involved in the control of atrial fibrillation include the resetting of the heart rate and rhythm, and the active prevention of blood clot formation. Conservative approaches to atrial fibrillation using medications to control rhythm is primarily sought before invasive procedures are implored. Some patients presenting with an organic disease like hyperthyroidism that induces atrial fibrillation may be treated accordingly to relieve the heart of these unnecessary stresses.

To reset the heart to normal rhythm, physicians often resort to cardioversion of the heart which may done by either electrical means (Electrical cardioversion), and by medical cardioversion. When the abnormal rhythm is normalized after electrical cardioversion, patients are often given antiarrhythmic drugs like flecainide, propafenone, dofetilide, and amiodarone to prevent the recurrence of the atrial dysrhythmia. Medications to control resting heart rate may be given like digoxin, beta blockers, and calcium channel blockers although proper precautions must be made to prevent hypotension [10].

In cases, where medical cardioversion fails to achieve its goals, surgical approaches like cardiac catheter ablation, atrio-ventricular node (AV node) ablation, and surgical maze procedures may be the only options left. Patients with atrial fibrillation are at high risk for the development of thrombi and embolus from blood clots; thus, anticoagulation therapy like warfarin, dabigatran, rivaroxaban, and apixaban may be given as a preventive measure.

Atrial fibrillation is closely associated with thromboembolic events that is why patients with AF have up to 1.9 fold risk of death compared to those who don’t suffer from it [6]. Mild asymptomatic AF has a good long term prognosis. The administration of maintenance medications like rate control and anticoagulants does not increase the survival rating of AF patients that are asymptomatic [7].

The risk of a thromboembolic stroke among AF patients beyond 75 years of age is staggering; thus, anticoagulant therapy is perpetually given unless other contraindications are identified. Meta-analysis data revealed that patients who were brought to the emergency room with myocardial infarction presenting with AF have a 40% increase in mortality rate [8].

Atrial fibrillation may be induced by any of these conditions:

• Coronary artery disease (CAD)
• History of heart surgery
• Viral endocarditis
• Sick sinus syndrome
• Sleep apnea
• Pneumonia and other lung diseases
• Stimulants like coffee, tobacco, alcohol and medications
• Hyperthyroidism
• Electrolyte imbalance
• Heart valve abnormalities
• Congenital heart disease
• Neurologic disorders
• Carditis and pericarditis
• Genetic factors

In the United States alone, more than 2.2 million Americans are suffering from atrial fibrillation. This cardiac dysfunction is primarily age related, because a fourth of the patients beyond 40 years old are at risk of developing atrial fibrillation in their remaining lifetime [2].

The increasing prevalence of atrial fibrillation among the elderly population is expected to double by 2050 in the US. Atrial fibrillation is relatively rare in infants and childhood, except for those who have undergone prior cardiac surgery [3]. Atrial fibrillation is more common among males than in females, and it is commonly seen in the white race than the black. Patients reaching the seventh decade the prevalence doubles per 10 year increment [4].

Arial fibrillation is strongly associated with cardiovascular diseases like coronary artery diseases (CAD), congestive heart failure (CHF) and diabetes mellitus [5]. Although the exact mechanism is inconclusively elaborated, theories abound that excessive catecholamine, hemodynamic stress and cardiac inflammation causes the AF phenomenon. There are theories of the occurrence of an automatic focus of electrical conduction from sources other than the AV node like some focal regions in the pulmonary vein can cause the unsynchronized impulses that gives rise to AF.

The active prevention of heart diseases through a heart friendly diet, exercise, and lifestyle may prevent occurrence of an acquired atrial fibrillation. A healthy lifestyle connotes the willful avoidance of stimulants like caffeine, alcohol and tobacco. Regular exercises and physical activity to maintain ideal body weight is also paramount in the prevention of heart diseases. Patients must understand that severe anger and stress can directly cause heart rhythm dysfunction on a long term basis.

Atrial fibrillation (AF) is clinically defined as a fast and irregular heart rate that reduces blood flow all over the body. Although atrial fibrillation is not considered life-threatening, persistent symptoms may require immediate treatment to prevent serious complications.

The desynchronized atrial contraction in atrial fibrillation may lead to thrombi or emboli formation that can functionally obstruct blood flow in multiple distant organs and cause ischemia. Atrial fibrillation is often times approached by interventions and medications to normalize the cardiac electrical activities. Atrial fibrillation is classified into three patterns: Paroxysmal AF, persistent AF, and permanent AF [1].

Definition

Atrial fibrillation is clinically defined as a fast and irregular heart rate that reduces blood flow all over the body.

Cause

Atrial fibrillation may be triggered by an ongoing heart disease, metabolic disease, neurologic disorders, and the intake of stimulants.

Symptoms

Patients may be asymptomatic, or may complain of palpitation, dizziness and weakness.

Diagnosis

Electrocardiography, echocardiography, Holter monitoring, blood tests and a chest X-ray may be used to diagnose the condition.

Treatment and follow-up

Medical and electrical cardioversion, and cardiac surgery ablation are the most common treatment options.

1. Fuster V, Rydén LE, Asinger RW, et al. ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology. Circulation. Oct 23 2001; 104(17):2118-50.
2. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. Aug 31 2004; 110(9):1042-6.
3. Abdel Latif A, Messinger-Rapport BJ. Should nursing home residents with atrial fibrillation be ant coagulated? Cleve Clin J Med. Jan 2004; 71(1):40-4.
4. Rathore SS, Berger AK, Weinfurt KP, Schulman KA, Oetgen WJ, Gersh BJ, et al. Acute myocardial infarction complicated by atrial fibrillation in the elderly: prevalence and outcomes. Circulation. Mar 7 2000; 101(9):969-74.
5. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. Oct 16 1998; 82(8A):2N-9N.
6. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. Aug 1991; 22(8):983-8.
7. Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. Dec 5 2002; 347(23):1825-33.
8. Jabre P, Roger VL, Murad MH, et al. Mortality associated with atrial fibrillation in patients with myocardial infarction: a systematic review and meta-analysis. Circulation. Apr 19 2011; 123(15):1587-93.
9. Klein AL, Grimm RA, Murray RD, Apperson-Hansen C, Asinger RW, Black IW, et al. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. N Engl J Med. May 10 2001; 344(19):1411-20.
10. Hagens VE, Ranchor AV, Van Sonderen E, Bosker HA, Kamp O, Tijssen JG, et al. Effect of rate or rhythm control on quality of life in persistent atrial fibrillation. Results from the Rate Control Versus Electrical Cardioversion (RACE) Study. J Am Coll Cardiol. Jan 21 2004; 43(2):241-7.