Atrial Fibrillation (AFib)

  • Medical Author:
    Daniel Lee Kulick, MD, FACC, FSCAI

    Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Quick GuideAtrial Fibrillation: Heart Symptoms, Diagnosis & Treatment for AFib

Atrial Fibrillation: Heart Symptoms, Diagnosis & Treatment for AFib

How is atrial fibrillation (AFib) diagnosed?

Atrial fibrillation can be chronic and sustained, or brief and intermittent (paroxysmal). Paroxysmal atrial fibrillation refers to intermittent episodes of AFib lasting, for example, minutes to hours. The heart rate reverts to normal between episodes. In chronic, sustained atrial fibrillation, the atria fibrillate all of the time. Chronic, sustained atrial fibrillation is not difficult to diagnose. Doctors can hear the rapid and irregular heartbeats using a stethoscope. Abnormal heartbeats also can be felt by taking a patient's pulse.

Tests for atrial fibrillation

EKG (electrocardiogram): An electrocardiogram (EKG) is a brief recording of the heart's electrical discharges. The irregular EKG tracings of AFib are easy to recognize provided AFib occurs during the EKG.

Echocardiography: Echocardiography uses ultrasound waves to produce images of the heart's chambers and valves and the lining around the heart (pericardium). Conditions that may accompany AFib such as mitral valve prolapse, rheumatic valve diseases, and pericarditis (inflammation of the "sack" surrounding the heart) can be detected with echocardiography. Echocardiography also is useful in measuring the size of the atrial chambers. Atrial size is an important factor in determining how a patient responds to treatment for AFib. For instance, it is more difficult to achieve and maintain a normal heart rhythm in patients with enlarged atria.

Transesophageal echocardiography (TEE): Transesophageal echocardiography (TEE) is a special echocardiographic technique that involves taking pictures of the atria using sound waves. A special probe that generates sound waves is placed in the esophagus (the food pipe connecting the mouth to the stomach). The probe is located at the end of a long flexible tube that is inserted through the mouth into the esophagus. This technique brings the probe very close to the heart (which lies just in front of the esophagus). Sound waves generated by the probe are bounced off of the structures within the heart, and the reflected sound waves are used to form a picture of the heart. TEE is very accurate for detecting blood clots in the atria as well as for measuring the size of the atria. Continue Reading

Reviewed on 5/27/2015
References
Medically reviewed by: Robert J. Bryg, MD; Board Certified Internal Medicine with subspecialty in Cardiovascular Disease.

REFERENCES:

UpToDate. Patient information: Atrial fibrillation (Beyond the Basics).

Wann, Samuel L., et al. "2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (Updating the 2006 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines." Journal of the American College of Cardiology 57.2 (2011): 223-242.

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