Atrial fibrillation - discharge
Auricular fibrillation - discharge; A-fib - discharge; AF - discharge; Afib - discharge
Atrial fibrillation or flutter is a common type of abnormal heartbeat. The heart rhythm is fast and irregular. You were in the hospital to treat this condition.
When You're in the Hospital
You may have been in the hospital because you have atrial fibrillation. This condition occurs when your heart beats irregularly and often faster than normal. You may have developed this problem while you were in the hospital for a heart attack, heart surgery, or other serious illness such as pneumonia or injury.
Treatments you may have received include:
- Pacemaker
- Cardioversion (this is a procedure done to change the beat of your heart back to normal. It can be done with medicine or an electric shock.)
- Cardiac ablation
You may have been given medicines to change your heartbeat or slow it down. Some are:
- Beta blockers, such as metoprolol (Lopressor, Toprol-XL) or atenolol (Senormin, Tenormin)
- Calcium channel blockers, such as diltiazem (Cardizem, Tiazac) or verapamil (Calan, Verelan)
- Digoxin
- Antiarrhythmics (medicines that control heart rhythm), such as amiodarone (Cordarone, Pacerone), flecainide (Tambocor), or sotalol (Betapace)
A lot of things can make your heart beat faster, like kissing the person you love or watching a scary movie. But sometimes, your heart beats not only faster but also out of rhythm. That can be a problem if this continues over a long period of time and isn't treated. Let's talk about a condition called atrial fibrillation. If you can listen to your heart through a stethoscope, your heart beat should sound something like this, or lub dub, lub dub, lub dub. If you have atrial fibrillation, the top two chambers of your heart contract too quickly, and in an irregular pattern. So what you'd hear if you listened through a stethoscope would be more like this. Atrial fibrillation doesn't just sound funny, this irregular beat can prevent your heart from pumping enough blood out to the rest of your body. Age may cause atrial fibrillation. As you get older, it's more common to have an irregular heartbeat. You're also more likely to have atrial fibrillation if you've had another heart problem, like valve disease, coronary artery disease, or heart failure. Some people get atrial fibrillation because they drink too much alcohol or take certain medicines. To find out you may have atrial fibrillation. You'll feel your heart race and flutter-and not just once in a while, but often. You may also have trouble breathing and feel tired and dizzy. Your doctor can listen for fluttering while listening to your heart with a stethoscope. You may also need a test that records your heart's rhythms, like an ECG, which you have in your doctor's office, or a Holter monitor that you wear around for a day. Your doctor may also prescribe imaging tests to look at your heart and check whether its electrical system is working properly. If you do have atrial fibrillation, your doctor can give you medicine to slow your racing heart. Often, the next step is to restore the normal heart rhythm with an electric shock, a process called Cardioversion. However, if the atria haven't been contracting well for 48 hours or more, blood clots may have formed there. These patients are usually given anti-coagulant medicines before Cardioversion to prevent the clots from moving to the brain and causing a stroke when normal rhythm is restored. If Cardioversion doesn't solve the problem, a procedure called Cardiac ablation can be done to destroy the bad areas of your heart that are causing your heart to beat abnormally. Usually doctors can treat atrial fibrillation so that it becomes a minor nuisance, instead of a big problem. But, the condition can come back, even after it's been treated. If it continues, atrial fibrillation can lead to heart failure. To avoid complications from atrial fibrillation, call your doctor if you're feeling flutters in your chest, and they don't go away.
Taking Your Medicines
Have all of your prescriptions filled before you go home. You should take your medicines the way your health care provider has told you to.
- Tell your provider about other medicines you are taking including over-the-counter medicines, herbs, or supplements. Ask if it is OK to keep taking these. Also, tell your provider if you are taking antacids.
- Never stop taking any of your medicines without first talking to your provider. Do not skip a dose unless you are told to.
- Sometimes certain medicines are prescribed to be taken only when you have symptoms. Be sure you understand when to take your medicines.
You may be taking aspirin or clopidogrel (Plavix), prasugrel (Effient), ticagrelor (Brilinta), warfarin (Coumadin), heparin, or another blood thinner such as apixiban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa) to help keep your blood from clotting.
If you are taking any blood thinner:
- You need to watch for any bleeding or bruising, and let your provider know if it happens.
- Tell dentist, pharmacist, and other providers that you are taking this drug.
- You will need to have extra blood tests to make sure your dose is correct if you are taking warfarin.
Lifestyle
Limit how much alcohol you drink. Ask your provider when it is OK to drink, and how much is safe.
Do not smoke cigarettes. If you do smoke, your provider can help you quit.
Follow a heart healthy diet.
- Avoid salty and fatty foods.
- Stay away from fast-food restaurants.
- Your provider can refer you to a dietitian, who can help you plan a healthy diet.
- If you take warfarin, do not make big changes in your diet or take vitamins without checking with your provider.
Try to avoid stressful situations.
- Tell your provider if you feel stressed or sad.
- Talking to a counselor may help.
Learn how to check your pulse, and check it every day.
- It is better to take your own pulse than to use a machine.
- A machine may be less accurate because of atrial fibrillation.
Limit the amount of caffeine you drink (found in coffee, tea, colas, and many other beverages.)
Do not use cocaine, amphetamines, or any other illegal drugs. They may make your heart beat faster, and cause permanent damage to your heart.
Ask your provider for recommendations for physical activity and exercise.
When to Call the Doctor
Call for emergency help if you feel:
- Pain, pressure, tightness, or heaviness in your chest, arm, neck, or jaw
- Shortness of breath
- Gas pains or indigestion
- Sweaty, or if you lose color
- Lightheaded
- Fast heartbeat, irregular heartbeat, or your heart is pounding uncomfortably
- Numbness or weakness in your face, arm, or leg
- Blurry or decreased vision
- Problems speaking or understanding speech
- Dizziness, loss of balance, or falling
- Severe headache
- Bleeding
References
Calkins H, Tomaselli GF, Morady F. Atrial fibrillation: clinical features, mechanisms, and management. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 66.
January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):e1-76. PMID: 24685669
January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019;74:104–132. PMID: 30686041
Zimetbaum P. Supraventricular cardiac arrhythmias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 58.
Version Info
Last reviewed on: 1/1/2023
Reviewed by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
