What is atrial fibrillation?

What is AF? AF (or Afib) is a common type of irregular heart rhythm. AF is a medical abbreviation which means ‘atrial fibrillation’. This term refers to the atria (the two upper chambers of the heart which receive blood from your veins and push this blood into your ventricles). It also refers to fibrillation, meaning to quiver or contract spontaneously.

AF occurs when the atria experience chaotic electrical signals, causing them to ‘quiver’ rather than contract in a coordinated manner. This irregular and rapid electrical activity can disrupt the normal heart rhythm and lead to a variety of symptoms and potential health issues.

What are the symptoms of atrial fibrillation?

AF is associated with a range of symptoms, but not everyone with AF presents noticeable symptoms. Some people may have ‘silent’ AF, where the condition is detected during routine medical checkups – in other words, they do not experience the overt symptoms of atrial fibrillation. Other people may display typical symptoms simultaneously, such as heart palpitations and tiredness.

When symptoms of atrial fibrillation are present, they can vary in severity. The following are the most common symptoms of Afib:

1. Palpitations

The most common symptom of atrial fibrillation is heart palpitations. Atrial ‘flutter’ symptoms are a fluttering sensation or irregular, or rapid, beating of the heart. A heartbeat of more than 100 beats per minute is considered rapid – you can check your own heart rate by feeling your neck or wrist and counting the beats per minute.

Heart palpitations can last for a few seconds up until a few minutes. Some people describe this as a ‘quivering’ of the heart. Others may describe the sensation as twitching, fluttering, or spasming in the chest.

2. Fatigue

An AF heart condition can cause persistent tiredness or a lack of energy. This is due to the heart’s inefficient pumping of blood, which hinders the oxygen and nutrient rich blood which is distributed around the body. This can cause tiredness, sluggishness and fatigue.

3. Shortness of Breath

Some individuals with AF may feel breathless, especially during physical activity or exertion. This is because the heart works harder to meet the body’s demand for oxygen. An elevated heart rate can lead to an increased respiratory rate, making you feel like you’re out of breath.

4. Chest Pain or Discomfort

Chest pain, pressure, or discomfort may occur in people with AF, although it is less common than in other heart conditions like angina. If someone is experiencing anxiety or stress due to atrial fibrillation, this may manifest as chest discomfort or a feeling of tightness.

5. Dizziness or Lightheadedness

Afib can lead to a drop in blood pressure and reduced blood flow to the brain, resulting in dizziness or a feeling of lightheadedness. The severity of dizziness in AF can vary from person to person.

When should I be worried about an irregular heartbeat?

Everyone experiences a fluttering sensation in their hearts at some point during their lives; this ‘skipping a beat’ feeling can be brought on by a number of emotions, including excitement or nervousness.

However, you should go and see your doctor if you are experiencing frequent, rapid palpitations that last for a prolonged period of time. Remember, a rapid heartbeat is more than 100 beats per minute, and you can measure this at home by feeling your wrist or neck. You should also schedule an appointment if you experience chest pain or breathlessness. Your doctor can run some tests to see whether these palpitations are harmless or a sign of an underlying condition.

How is atrial fibrillation diagnosed?

If your doctor suspects you have atrial fibrillation, they will conduct a few tests to determine this. First, a pulse test is carried out, where your heartbeats will be measured within a time frame. A pulse of more than 100 beats per minute is an indication of atrial fibrillation.

The next step in diagnosis is an electrocardiogram (ECG), which measures the electrical activity of the heart and can detect an irregular pulse.

Finally, blood tests may be conducted to check for underlying conditions that could be causing or contributing to AF, such as thyroid problems or electrolyte imbalances.

Atrial fibrillation treatments

Treatment for atrial fibrillation depends on a person’s age, overall health, type of AF and underlying causes. The first step of treatment will be to determine any underlying causes for an AF heart condition. For example, if you have an overactive thyroid gland (hyperthyroidism), treating it may also cure atrial fibrillation.

If no underlying causes of atrial fibrillation can be found, treatment options can include the following:

1. Rate Control

The primary goal of rate control is to slow down the excessively fast and irregular heart rate associated with atrial fibrillation. A normal resting heart rate of fewer than 90 beats per minute can be achieved using drugs for atrial fibrillation. These include beta-blockers or calcium channel blockers.

2. Rhythm Control

Rhythm control aims to restore and maintain a normal heart rhythm. This can be achieved through various methods. The first is an electrical cardioversion, which delivers an electric shock to the heart to reset its rhythm to normal.

Catheter ablation can also control an irregular pulse. Ablation is a procedure which involves using catheters (thin tubes) to create scar tissue in the heart. This can help break up the electrical signals that cause rapid, irregular heartbeats.

Finally, antiarrhythmic medications are drugs which help maintain a normal heart rhythm and prevent AF recurrences.

3. Anticoagulation (Blood-Thinning) Therapy

Atrial fibrillation is associated with an increased risk factor for heart attack or stroke, due to the risk of blood clots in the atria. Typical drugs for atrial fibrillation are blood thinners, which may be prescribed to reduce the risk of stroke by preventing blood clot formation. The choice of blood thinner depends on individual risk factors and preferences.

4. Lifestyle Changes

Living with atrial fibrillation requires some lifestyle changes to help manage the condition. These include managing underlying health conditions, such as high blood pressure and diabetes; achieving and maintaining a healthy weight; and regular physical activity (which is possible and actively encouraged, bearing in mind some precautions).

5. Implantable Devices

Some individuals with an AF heart condition may benefit from implantable devices like pacemakers or implantable cardioverter-defibrillators (ICDs) to help control heart rhythm or manage complications.

My heartbeats are not constantly irregular – what does this mean?

If your irregular, rapid heartbeat seems to ‘come and go’, you may have what is known as paroxysmal atrial fibrillation (medically abbreviated as ‘paf’). In paf, abnormal heart rhythms occur intermittently and spontaneously but then return to normal rhythm on their own, usually within a few days. These episodes can last for a few seconds, minutes, hours, or even days, but usually cease on their own.

Paroxysmal atrial fibrillation can occur as a result of the same triggers as atrial fibrillation; namely poor diet, smoking, caffeine, alcohol and stress. As we have mentioned before, both forms of atrial fibrillation can also be caused by underlying health conditions, such as thyroid problems, that should be identified before starting any treatment.

What does af mean for my lifestyle?

When you first get diagnosed with Afib, it is important to take time to understand your condition and not to rush into any drastic life changes immediately. Make sure to read any resources given to you by your doctor, and go to your appointment with questions you have thought about in advance.

Once you have understood exactly what atrial fibrillation is, your doctor will speak to you about treatment options. However, outside of medical intervention through treatment, there are lifestyle changes that you should consider making that will help reduce your symptoms and the health implications of the condition.

Make sure to consult your doctor before making the following lifestyle changes:

1. Move towards a heart healthy diet

A heart-healthy diet can help control weight and blood pressure, which are important for managing AFib. Consider a diet rich in fruits, vegetables, whole grains, lean protein, and low in saturated fats, cholesterol, and sodium. Read our 15 Easy Food Swaps article for ideas.

2. Maintain a healthy weight

Being overweight or obese can increase the risk of atrial fibrillation and worsen its effects. Losing excess weight through a combination of diet and exercise can help.

3. Limit alcohol and caffeine

Excessive alcohol and caffeine consumption can trigger atrial fibrillation episodes in some people. Reducing or eliminating these substances from your diet may be beneficial.

4. Quit Smoking

Smoking is a significant risk factor for heart disease and can trigger and exacerbate AFib. Quitting smoking is one of the most important steps you can take for heart health.

5. Exercise

Regular physical activity can help improve overall cardiovascular health. Cardiac Lauren is the perfect programme for people suffering from AF. Lauren will explain the importance of a 15-minute warm-up and 10-minute cool-down to help prevent further irregular heart rates and participants find they are able to cope with a full exercise session when they incorporate these elements. Please note that if you are using smartwatches and heart rate monitors to monitor yourself during an exercise session, be aware that they are not great at picking up your heart rate. They often ‘guess’ the rate as the atria are contracting at different times. Watch this short video explaining more HERE.

6. Manage Stress

High stress levels can trigger atrial fibrillation or make it worse. Practices such as relaxation techniques, yoga, meditation, or deep breathing exercises can help manage stress.

7. Stay Hydrated

Dehydration can trigger AFib episodes, so it’s essential to stay well-hydrated, but avoid excessive fluid intake.

Living with atrial fibrillation also means attending regular appointments with your healthcare practitioner, to check in, discuss symptoms and ensure that you are on the most effective treatment plan. It may also involve taking daily medications as directed by your doctor.

How long can you live with an irregular heartbeat?

AFib itself does not necessarily reduce life expectancy on its own. However, AFib is often associated with an increased risk of certain complications, such as stroke, heart failure, and other cardiovascular problems. If AFib is well-managed and a person receives appropriate treatment and makes lifestyle changes to control risk factors, their life expectancy may not be significantly affected.

Again, it is important to note that following the treatment and recommendations from your doctor is extremely important; this will ensure a minimal impact on your life expectancy. Although atrial fibrillation has been linked to a reduced life expectancy due to risks of stroke and heart failure, many people with atrial fibrillation also live normal lives.

After a heart event, it is normal to feel anxious and unsure about your recovery. Many people aren’t sure about which activities they can resume and which to avoid, as well as understand the steps to their rehabilitation when they can return to work.

We believe that knowledge is power when it comes to recovering from a mild heart attack, in order for the individual to take back control of their health; avoid complications or setbacks; and continue to enjoy their life to the fullest.

Myocardial infarction - heart attack - mild heart attack

What is a mild heart attack?

Older man walking and mild heart attack, angina, chest pain

The term ‘mild’ is used to describe a heart attack in which the blood supply to the heart becomes only partially blocked, as opposed to total blockage for a prolonged period of time. A ‘mild’ heart attack is formally known in the medical world as a Non-ST segment elevation myocardial infarction (NSTEMI) as opposed to the more severe ST-segment elevation myocardial infarction (STEMI). Nevertheless, a mild heart attack is still a serious medical event and one that can be deeply upsetting. The positive news is that recovery programmes are well-researched and trusted, to give you the best chance of avoiding future heart events and getting back to normal life. Many people make a full recovery from a heart attack.

Phase 1: What to expect after a mild heart attack while still in hospital

What to expect after having a mild heart attack

After a mild heart attack, you may remain in the hospital to receive medical treatment and undergo diagnostic tests to determine the extent of damage to your heart. This is known as ‘Phase 1’ and the main goals during this time are to stabilise the patient, prevent further damage and initiate treatments to help the heart muscles recover.

Your hospital treatment plan in Phase 1 will depend on the severity of the heart attack and any underlying medical conditions you may have. Generally, treatment may include medications such as aspirin, nitroglycerin, beta-blockers, or statins to manage symptoms, improve blood flow to the heart, and reduce the risk of further heart attacks.

If you have had angioplasty or stents following your mild heart attack – a painless procedure used to open up narrowed or blocked arteries – you can expect to be in the hospital for about 2-3 days. Any other procedures or surgeries follow more severe (STEMI) heart events, where recovery time in the hospital will be longer.

Heart, blood flow through a healthy artery,, blocked artery, angiogram, angioplasty stent pci — **Left: the heart with veins and arteries. Top right: blood flowing through a healthy artery.**
**Bottom right: blocked artery, angiogram, angioplasty, stent fitted into the artery.**

You may also receive consultation on lifestyle changes you should make, such as adopting a heart-healthy diet, quitting smoking, reducing alcohol consumption, and engaging in regular physical activity.

When your doctor decides that you are in a stable condition to go home and begin your recovery, you will be discharged from the hospital. The summary notes from the hospital will have been forwarded to the local NHS cardiac rehabilitation team and they will make contact by phone.

For more information about Phase 1 after a mild heart attack, click here.

Phase 2: what to expect after a mild heart event after hospital discharge

Recovering from a heart attack at home can be a gradual process which requires the patient to be disciplined and proactive about their health. Alongside the NHS cardiac rehabilitation team who you will be in contact with, you will be responsible for your own recovery – but don’t worry: the main thing to do in Phase 2 is rest and take it easy.

You can expect to feel tired and sluggish when you return home, however, the key here is to continue doing light household activities. These include getting up and getting dressed in the morning; washing; making hot drinks; going up and down the stairs; washing up and going for short walks.

It is recommended that a trusted person stays with you to help out, however, you should also try to be as independent as possible.

Aside from rest, you will need to follow the instructions given to you by your doctor, which are likely to include taking medication at the correct times. Other tasks you will need to do as follows:

Remember to:

Cardiac nurse phase 2 recovery at home cardiac rehab

Take your discharge letter from the hospital to your GP or ask a loved one to do it. This allows your GP to know about your heart attack and the treatment you’ve had.
Make an appointment to see your GP within the first couple of weeks of being home so that you can get a repeat prescription for your medicines.
Take your medication according to your schedule.
Attend your follow-up appointment at the hospital.
It is also important to look out for your mental well-being after a mild heart attack. It is common to feel anxious, depressed, overwhelmed or hopeless after this upsetting event.

You can visit the British Heart Foundation’s emotional support page here. They also have an online magazine called Heart Matters about learning to cope with your diagnosis – Cardiac Lauren is a fan of this magazine.

Mind is also a mental health charity with many resources to support you. Why not check out their online community, Elefriends, to chat with those who might be experiencing the same feelings as you?

You could also visit the NHS self-help webpage to read about online or remote services that can improve your mental well-being.

For more information about Phase 2 after a mild heart attack, click here.

Phase 3: your active recovery programme after a mild heart attack

In Phase 3, education, exercise and support from a multidisciplinary team are put together in a 4–12-week programme. The primary goal of Phase 3 cardiac rehabilitation is to help individuals return to their normal daily activities and improve their overall health and well-being.

The individual takes on more responsibility for their recovery after the mild heart event, as they build up to be able to complete 20 minutes of continuous activity safely (being able to monitor their own capability and intensity).

Patients will become very familiar with RPE, which stands for Rating of Perceived Exertion, during Phase 3 recovery. This is a subjective measure of how hard someone feels they are exercising – to help people gauge their intensity level during physical activity. Anywhere between RPE 11 & 14 is generally desired – i.e. ‘fairly light’ to ‘somewhat hard’.

Phase 3 recovery after a mild heart attack sees the patient become physically stronger and more knowledgeable about their condition.

More information about Phase 3 recovery after a mild heart attack can be found here .

Level 1 - workout a - phase 3 cardiac rehabilitation exercise video

Level 3 - workout a - phase 3 cardiac rehabilitation exercise video

Phase 4 recovery after a mild heart attack

Phase 4 cardiac rehabilitation is where the fun starts! You will have built up strength and a generally enhanced well-being after your Phase 3 exercise and education programme, which means you are now ready to start reaping the benefits of regular fun, challenging and, crucially, safe exercise.

Joining Phase 4 cardiac rehabilitation exercise classes can be life-enhancing and build your strength, mood and confidence while living with a history of a mild heart attack.

Cardiac Lauren offers friendly and convenient online classes to suit all Phase 4 patients after a mild heart event – whether they are used to regular exercise or are just starting their fitness journey.

My participants love the fact that they can choose when to exercise and which style and intensity of class to do each time.

All intensity levels - arms & legs in all directions

Choose your plan and get started here.

Heart Events