How Do You Know If You Have AFib?

What Does AFib Feel Like?

Travis and Jeffrey share their stories about what AFib feels like.

Atrial fibrillation (AFib) is a condition that often produces a variety of unusual feelings and odd sensations. Many people with AFib experience symptoms that can range from mild to debilitating, depending on the form of AFib they have.

AFib symptoms happen because of the incomplete contraction of the atria resulting from a disruption in the heart’s normal electrical conduction. AF can then cause the ventricles to fire erratically at rates between 100 to 200 beats per minute.

If you have AFib, chances are you have experienced some, if not all, of its associated warning signs.

What Happens When the Heart is in AFib

When your heart is its normal rhythm, it beats twice synchronously: once each when the atria and the ventricles contract. If you use a stethoscope to listen to these contractions, you will hear a “lub-dub" sound.

When your heart is in AFib, the atrial and ventricular chambers are out of sync and racing, so there is no “lub-dub" sound. The heart muscle also quivers because it is unable to pump forcefully enough to allow for complete contractions.

What Do the Symptoms Feel Like?

With any disease, the first question that comes to mind is what are the symptoms? Most people are symptomatic, so when they go into AFib, they know something isn't right.

The Symptoms of AFib

For some people, atrial fibrillation can start with a skipped beat coupled with a “thump"-like feeling, followed by a racing heart rate. The most regularly reported symptoms people experience with AFib are:

• Anxiety
• Chest discomfort
• Confusion
• Dizziness
• Feeling faint
• Fatigue - feeling drained physically after an occurrence
• Inability to exercise
• Nausea
• Palpitations that feel like a fluttering, pounding, or racing heartbeat
• Shortness of breath due to inadequate atrial and ventricular chamber filling, resulting in reduced oxygen delivery to the rest of the body
• Sweating
• Weakness

Symptoms of AFib differ between individuals, and depend on factors such as age, ethnicity, the primary cause of the AFib, and the number of cardiac risk factors present:

• Cardiologists conducted a research study at the University of Foggia in Italy in 2012 that found elderly individuals over the age of 70 may have atrial fibrillation without feeling symptoms.
• According to a study from 2016 in the American Heart Journal, Black patients tend to experience more symptoms than White or Hispanic patients because of a higher number of cardiac risk factors.

Mild to incapacitating symptoms can occur and are dependent on the type of AFib you have:

• Paroxysmal AFib happens randomly with definite warning signs, can last up to seven days, and can resolve on its own. Paroxysmal AFib can cause anxiousness, shortness of breath, palpitations, a quick onset of weakness and fatigue, and can wake a person from sleep. People with this kind of AFib often feel physically exhausted after an occurrence.
• Persistent AFib is present for more than seven days, with symptoms identical to paroxysmal but less severe. Return to a normal rhythm requires medical treatment.
• Permanent AFib last several months or years and is not correctable with any medical treatment. Symptoms with this form are less intense than with persistent AFib, and may no longer be noticeable after a certain amount of time.

Some individuals experience no symptoms and are unaware that they have AFib until they undergo a physical examination.

Travis' AFib Diagnosis

I was diagnosed with AFib when I was just 32 years old. The other day a 22-year-old woman contacted me on my blog to say she was just diagnosed with it.

Atrial fibrillation doesn't discriminate. While it's true you're more likely to get it in your later years, you're not entirely immune to it if you're young.

This is especially true if AFib runs in your family. My dad was diagnosed with it at a relatively early age (50) and surprise surprise, I was diagnosed with it at an ever earlier age!

What Does AFib Feel Like? – Travis

When I had my first episode, I thought I was having a heart attack. Like the flip of a switch, my heart suddenly took off. My heart was racing and pounding out of my chest as if I had just completed a marathon.

This pounding and racing feeling is one of the most common symptoms of AFib. Another way it's often described is a large fish flopping in your chest.

Like a fish does if you pull it out of the water and put it on the ground, it flips and flops irregularly — and often times violently as it struggles being out of water. That's exactly what your heart feels like it's doing when you're in AFib — violent, irregular flip-flopping.

When people ask me how will they know if they are in AFib, I always respond with this simple reply: "Trust me. You'll know!"

The first thing people often assume is that they are having a heart attack. It's that dramatic of an experience for most people.

When I go into AFib, for example, not only do I know it immediately, but it completely renders me useless. I can't do anything but sit in a chair or lie down until I convert to normal sinus rhythm (NSR).

Not everyone has such a dramatic experience when they go into AFib. In fact, a lot of people can function normally despite it.

Sure they'll have symptoms, but they won't be so severe that it knocks them off their feet. These symptoms can include any of the following:

• Lightheadedness
• Dizziness
• Unusual fatigue (they get winded doing the simplest of things)
• A "butterfly" sensation in their chest
• Palpitations (faint or those heart-pounding palpitations)

What Does AFib Feel Like? – Jeffrey

My initial episode of AFib occurred the night of December 30, 2011. At the time, I was eating my favorite dessert of frozen blueberries mixed with vanilla ice cream.

My heart rate inexplicably accelerated, and I began experiencing tightness in my throat, a pounding chest pressure that was uncomfortable but not severe, dizziness, fatigue, and weakness. The occurrence lasted eight hours and required hospitalization for conversion with medication.

My first incident seemed the most severe as far as symptom intensity, or I may have grown accustomed to the sensations with later episodes. Each time, I worried that the AFib would not stop.

Jeffrey's Patient Experiences with AFib

As a clinical exercise physiologist, I have had the opportunity to work in cardiac rehab programs for more than 20 years. In that time, I’ve taken care of hundreds of clients with AFib.

Some of the most frequent comments I’ve heard from people about how AFib feels are:

• “My heart feels like it is fluttering “
• “I feel washed out."
• “My heart feels like it’s flip-flopping around inside my chest."
• “My heart feels like it’s beating fast enough to jump out of my chest."
• “I feel jittery and weak."
• “My heart took off on me like a race-horse."

Some clients reported feeling a forceful beat before AFib’s onset, followed by lightheadedness and an anxious sensation. In most cases, the person was immediately aware of when their heart rhythm changed.

In one instance, an elderly individual was walking on a treadmill when AFib began and had no idea it was happening because of an absence of symptoms.

A study in the June 2015 issue of Circulation demonstrated that most people with symptomatic AFib experienced a reduction in their physical and emotional quality of life.

What to Do When You Experience AFib Symptoms

Distinguishing between AFib and heart attack symptoms is tricky, so it’s important to seek prompt medical attention when they occur. Call 911 or your physician immediately if you experience:

• Mid chest pressure or pain lasting more than a few minutes that moves to the shoulders, arms, back, stomach, or neck and jaw
• Cold sweating
• Nausea

Stroke is a significant risk for people with AFib, and the following signs need a rapid medical intervention:

• Facial Droop
• Arm or leg weakness
• Slurred speech or trouble speaking
• Drooling

Timely medical attention will ensure that you receive the best care for your condition.

The Bottom Line

AFib symptoms are different for each person, and some people don’t experience any at all. For your safety, it is wise to report any unusual signs you feel, even if they are subtle.

Effective treatment of AFib requires regular medical assessment and follow-up. Informing your physician of symptoms when they occur aids with timely evaluation and appropriate treatment.

AFib symptoms are unpredictable but are manageable when you work in partnership with your healthcare team. Promptly addressing symptoms and getting them under control will allow you to lead a more fulfilling and enjoyable life.

Silent AFib

While most people will experience some degree of the symptoms highlighted above, not everyone does. A small percentage of people have what is called silent AFib. They are asymptomatic, meaning they don't have any symptoms, or they at least don't notice them.

For people like me who are highly symptomatic, it's hard to believe that someone can be in AFib and not even know it but it does happen.

The silent AFibber is usually diagnosed with atrial fibrillation when they go to the doctor for an annual physical or some other health issue. They'll be shocked when their doctor diagnoses them with AFib because they didn't feel anything!

How Do I Know If I Have AFib?

Most people will know when they go into AFib because the experience will be pretty dramatic or they'll have some degree of the symptoms mentioned earlier. The only way to officially diagnose it, however, is to have an ECG at the doctor's office or by wearing a heart monitor for a period of time prescribed by your doctor.

There are also consumer-grade heart monitors you can buy that don't require a prescription. These devices will allow you to take a quick ECG anywhere you are. Two of the most popular right now are the Kardia monitor by AliveCor and the HeartCheck Pen by CardioComm Solutions, Inc.

The Kardia monitor was created specifically to help diagnose AFib. It has a filter that will tell you instantly if you are possibly in AFib. If it detects that you might be in AFib, you can email the ECG to your doctor or AliveCor's ECG analysis service for confirmation.

Everyone is unique, so their experience with AFib will likely be unique as well. Some people like me are rendered completely useless when they go into AFib, while others either don't even feel it or they have symptoms, but they can function normally.

Regardless of where you fall on the spectrum, if you have AFib in your family or you've experienced any of the symptoms mentioned in this article, you should talk to your doctor.

If you're one of those types that don't like to go to the doctor unless necessary, then I encourage you to at least invest in one of the consumer-grade heart monitors.

Atrial fibrillation itself won't kill you, but the side effects of it can — so don't ignore it!