By Patty Weasler, RN, BSN
Published on November 02, 2023
Medically reviewed by Richard N. Fogoros, MD
Atrial fibrillation (A-fib) is the most commonly treated heart arrhythmia.1 It causes the upper chambers of the heart to beat fast, generating an inefficient heartbeat and increasing the risk of stroke. Anytime someone experiences A-fib for the first time, they should go to the hospital.
This article will discuss A-fib symptoms and when emergency 
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Atrial Fibrillation Emergency Symptoms
A-fib is a rapid, irregular heart rhythm in which the upper chambers of the heart (atria) beat chaotically, ineffectively, and at a very fast rate. This leads to ineffective emptying of the atria, thus increasing the risk of blood clots. It also reduces the efficiency of the lower cardiac chambers (ventricles), which lowers the ability of the heart to pump blood efficiently.2
A person can be in A-fib and not experience any symptoms. However, A-fib can cause emergency symptoms that need immediate medical attention. Call 911 for these symptoms:3
Sudden weakness
Numbness
Difficulty speaking or seeing
Chest pain or pressure
Shortness of breath
Pain or heaviness in the jaw, arm, or neck
Severe headache
Heart Rate vs. Heartbeat
A heart rate is the number of times per minute that the heart beats.
A heartbeat is when the heart goes through its normal sequence of moving blood from the heart to the body via muscular contractions of the heart chambers (atria and ventricles) and the opening and closing of valves.4
It starts when blood enters the right atrium and is pumped into the right ventricle. From the right ventricle, blood is pumped through the pulmonary artery to the lungs. From the lungs, it returns to the heart via the pulmonary veins to the left atrium.
Blood then moves to the left ventricle and then out of the heart via the aorta to the body. This entire sequence, or movement of blood, happens during every heartbeat.
Atrial Fibrillation Complications
The greatest risk associated with A-fib is that the arrhythmia can cause additional problems like a stroke or heart failure.5
Stroke
The increased risk of stroke is due to how the heart moves when it is in A-fib . The upper chambers of the heart are not fully contracting during A-fib. This results in some blood staying in the atria.
When blood pools in the atria, there is an increased chance of clot formation. These clots can then be pushed out of the heart to the brain, causing a stroke.5
Signs and Symptoms of Stroke
Heart Failure
Heart failure is another complication of atrial fibrillation. Heart failure is when the heart does not pump enough blood through the body.
When someone is in A-fib, their heart is beating very fast. This does not allow enough blood to fill the heart between contractions. This decreases the amount of blood pumped into the body.5
Without the strong heart contractions to move blood into the body, blood can back up into the pulmonary veins. The extra blood in these veins causes fluid to be pushed into the lungs. This is called pulmonary edema. Ultimately, less oxygen exchange in the lungs causes shortness of breath and fatigue.5
What Happens at Hospital for Atrial Fibrillation
When someone comes to the hospital for atrial fibrillation, their level of treatment will depend on how stable they are. They will be evaluated by a healthcare provider and given a few tests to make a diagnosis. The tests can include:2
Electrocardiogram (ECG or EKG): This test uses electrodes to detect the electrical activity of the heart.
Echocardiogram: This test uses sound waves to create images of the function of the heart and heart valves.
Blood tests
Someone who is stable and comes into the hospital for A-fib is likely to be treated with medications to control their heart rate and rhythm and an anticoagulant to prevent stroke.6
People who are in the hospital with unstable vital signs may be treated with intravenous (IV) medications or cardioverted. Cardioversion is when someone is shocked with electrical paddles or stickers placed on the chest. They will be sedated before they are shocked.6
After treatment at a hospital, healthcare providers will create a home plan for people with A-fib. The goal will be to reduce the incidence of A-fib and keep the heart rate and rhythm normal.
Atrial Fibrillation Heart Rate
When someone is in A-fib their atria (upper chambers of the heart) are moving at a very fast and irregular rate. The atrial rate can beat 400 or more times per minute.7 This is very rapid compared to the range of 60 to 150 beats per minute for a healthy person.
Managing Atrial Fibrillation Episodes at Home
If a person has had A-fib, their healthcare provider may have set them up with instructions on how to manage it at home. Most people will be taking medications daily to control their heart rate and an anticoagulant to reduce the risk of stroke. However, there is still a risk of developing A-fib.
Some steps to take to manage A-fib episodes at home are:8
Know your A-fib symptoms: Each person will have different symptoms from A-fib episodes. It's important to know your symptoms and what a typical A-fib episode feels like for you.
Pulse check: Check your pulse to determine how fast your heart is beating. A pulse check will also let you know if your heart is beating irregularly. Some people may have a wearable device that monitors heart rate and rhythm. These are helpful but can be unreliable.
Medication: If a healthcare provider has instructed you to take additional medication for A-fib episodes, follow those instructions.
Summary
Atrial fibrillation (A-fib) is an arrhythmia that increases a person's risk of stroke and heart failure. Immediate recognition and treatment can improve outcomes. For some people, A-fib is something they will deal with for the rest of their life.
A healthcare provider can provide a treatment plan that allows a person with A-fib to manage some of their symptoms at home. However, if symptoms worsen, it's vital that they seek immediate medical attention.
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