How can some people not notice Atrial Fibrillation?

Does anyone have any ideas or an answer to this question: -How do some people not notice their AF until they have a medical? How on Earth could you NOT notice it?? Its like to sparrows fighting it out in your chest cavity. Unless some have differing versions of it? Different focci points and distributions? Stabbing in the dark a bit here!

42 Replies

  • *TWO Sparrows!

  • Easy

    I thought my Asthma was actin up - nurse took pulse and found AF - now permanent

    Get exhausted and breathless but not aware of palpitations etc but am in permanent AF

  • I'm sorry you're in it permanently but-that doesn't really answer my question does it?

  • I don't think your question can be fully answered mate that's the point of my post.

    We seem to be all different in our symptoms

    By the way my Heart Rate continues to vary between 80 to 120 all the time and I am totally unaware of it

  • If your heart is beating at a normal rate it is highly likely that you would be unaware of an irregularity. This is the problem & the reason why the public are being encouraged by the AFA etc to ' know their pulse'. Those of us who experience fast AF could hardly be unaware of it.

  • As I said-to myself and 2 other people that I know, its so very apparent-it would be impossible not to feel it. And its not heightened awareness or anything like that.

  • As I said it is all to do with rate. You will find in time like many of us that once you have been diagnosed you are very likely to be highly tuned - in to your heart rate... sometimes a bit too much!! You will get used to it. Sandra

  • Sorry but just because YOU are aware of YOURS does not mean that everybody is. Asymptomatic AF is the real risk as those people who are unaware of it are not usually anticoagulated and it is those people who frequently only find out that they have AF when they have a stroke. I don't know, but suspect that when AF creeps in gradually then the body gets used to it and does not sound any alarm bells. I can't imagine not noticing but there ar plenty of members here whoi are persistent and have no synmptoms. As one leading EP told one of them You lucky bugger!

  • Agree with Sandra and Bob. I've found fast AF to be obvious but have had episodes of AF with a normal rate that were only picked up by an ECG. I've had episodes where it felt like a 20st person sitting on my chest, others where I can feel palpitations in various parts of my body and some where I have been breathless. When I am in slow AF, either I feel nothing or else just the occasional bump.

  • I certainly notice AF when it's obvious but after a while it can settle and is less evident. Eventually I can find I have reverted to NSR and I don't know when it happened. Sometimes I do notice a change in rhythm. I feel fairly OK when in AF - just aware of a silly, fast and irregular heartbeat that isn't consistent and can be 90 bpm or 150. I've never suffered from breathlessness.

  • I guess they don't notice because their hearts don't go as fast as ours. Or perhaps it could be to do with the way we are all built differently and also what the heart is doing physically at the time to make us aware of it - e.g. is the beat being activated from an abnormal source as mine sometimes does. My heart bangs in my chest quite a lot, once when it was like that my cardiologist said I had a lovely strong heartbeat! Huh!

  • I did not know what the racing of my heart was . Had it most of my life. Did not really identify the problem till I had afib attack along with blockages in my heart. It would take what seemed forever for my heart to settle down. Would be totally out of breath doing things normally I would have no problem doing. If this makes any sense, I didn't know I had it until they told me I had it.

  • I am 57 and my consultant thinks my AF started in my late teens or early 20's but was misdiagnosed! I am in persistent AF but I am not always aware of symptoms because I have infrahisian disease which means my ventricular rate is slow. My symptoms have varied a lot over the last three years. I had constant chest pain for just over two years but the last five weeks no Pain at all! I sometimes get palpitations and other symptoms. Reading comments on this forum we are all different and guess this is dependent not just on AF but any other underlying pathology and what exacerbates symptoms for each person.

  • Different horses for different courses.

    I do not understand how anyone can say that light exercise can help get rid of AF. I can hardly walk a few metres when I am in AF without my heart throwing a fit.

    Others talk about being in constant AF and I can't imagine being able to cope with that but it's because MY AF comes in roaring like a freight train, quickly escalating to 150+ BPM whereas for many people its more about it being an elevation with a few random beats.

    But I get that we all experience it differently an our symptoms vary.

    If there was a one size fits all we'd be cured by now! :)

  • When I was first diagnosed, my bpm was constant 143, don't know how long it had been like that as I couldnt feel it much to everyone's amazement. I went to the Dr's as I severely lost energy when walking fast or up stairs and he had me on meds for stress i thought it may be a side effect (different conversation but I believe those meds triggered my AF)

    Now post an ablation my Bpm varies between 70 and 140 and I can't feel any difference in my heart but if I have an episode I'm floored while it lasts and I guess an episode pushes my Bpm way up (I was hospitalised with a Bpm of 240 recently) again personally even that didn't feel much different from a heart perspective although the other symptoms made up for it.

    i could speculate that as I played a lot of competitive sport from teens up to my early 40's I'm used to my heart beating fast so don't notice it but not really sure why I can't tell.

  • I'm in AF all the time

    But I have asthma so my first knowledge was struggling to breath during exertion

    Kept pumping inhalers in

    Legs started to swell a bit

    Went To hospital after visit to doc

    Apart from breathing nothing noticeable

    Read my other

    Posts to see where I am now

  • Very easily indeed - it happened in my case!!!!

    With the benefit of what I now know about the symptoms (a lot of that is from this forum and AFA website) I certainly had AF developing for SOME YEARS but it was only picked up formally last September during a general anaesthetic for an eye operation (made it worse) and it was persistent at that point.

    It was easy to explain individual symptoms (and at least 7 or 8) away on this and that and the other, especially as none were dramatic. Some of that I rationalised on the basis that in my late 50s I was still trying to (and in many ways succeeding) doing things and living as if I was in my early 30s. I rarely had things wrong with me only visited doctor as last resort. In fact at the admission for the eye op both the nurse and the anaesthetist questioned me two or three times about the fact that I was not on any medicines or drugs (paracetamol occasionally) and both commented that it was unusual for someone who was 60 not to be taking anything. I can't blame them for tempting fait!!!

    My lifestyle was hectic and "adrenaline fuelled". Traditionally my heart beat was low (55 to 65) but it was some years since it was checked.

    I wish I had had information and checks to have picked up AF and nipped it in the bud some years ago!!! BTW I had never heard of AF until September last year.

  • I meant to add with looking back I can clearly identify 3 step change points over the last five years and possibly a couple of others. Hindsight is no good in the case of AF!!!

  • Thanks for all of your replies-I didn't expect that large a response!

    The overwhelming opinion is that its horses for courses and-its better to have symptoms- to avoid strokes.


  • Well summarised.

    It would be interesting to know what % of undiagnosed AFers who had strokes were in persistent AF and what % just had no symptoms (whether persistent or Paroxysmal). Then the % who had it diagnosed but were not on anticoagulants.

    From reading the posts on HUB my feeling is that many of those who have Paroxysmal AF know about it because they seem to have big swings between "normal" and "AF incidents". Maybe I am wrong?

  • I was diagnosis with PAF about 2 years ago. The attacks were very bad and kept rushing to A and E.

    Like you , I couldn't believe anyone COULD NOT KNOW !!

    Now I'm in permanent AF and barely notice it.

    I much prefer this to PAF.

    We do seem to get used to it with time but I'm sure I'm like everyone else and wish it in hell.

    Thinking of you. Good luck. Bebe.

  • I knew something was wrong but really didn't feel palpitations. My symptoms were excess urination during the night with a faint in AM . Went to clinic and they said I was dehydrated; didn't do any testing as by then I was in NSR.

    Heather R

  • Interestingly, my cardiologist said he had hundreds of patients who had no symptoms of AF and it was only picked up in A&E or during a health check.

  • I had AF return 8-9 years after my ablation and it was nothing more than a tiny twitching / muscle spasm under my left armpit. A bit like when you get a twitch in your eye, but not as annoying.

    It could have easily been ignored and I nearly did. But I was seeing my EP anyhow so mentioned it and he fitted a monitor and confirmed it was AF.


  • I was completely unaware of having AF until it was picked up on a 7 day monitor 2 months after having a spinal stroke. Prior to the stroke, I had been feeling unusually tired and a feeling of 'impending doom' that I couldn't link to anything except the fact that I had been particularly busy at work with several tight time frames to meet. I was eventually diagnosed with PAF but I still don't feel it very often unless I'm lying in bed. I think the lucky ones are those that feel their AF; at least it acts as a warning allowing treatment and stroke prevention

  • I wish I didn't feel it then I would stop worrying about it. I am in persistent AF and have been since mid Feb when my last cardioversion failed. I am aware of my irregular HB all the time and feel breathless although my rhythm is well controlled around 80. We are all so different.


  • I have had AF since january 2014 (diagnosed) and I too had few symtoms, most of odd sysmtoms I put down a stressful few years with family health problems and just getting older (age 68). I did not have anything jumping around in my chest ( birds or frogs ect). For years I have known that I have a iregular heart beat at odd times. I have had times when I have felt tired and unwell for no know reason. Even when I was taken into hospital in Jnuary 2014 with a hr jumping between 160 to 200 I did not feel pain or my heart racing. I will get round to telling you my story behind my admission one day, a complete cock up at my gp surgery over a 3 month period. Anway I was admitted as an emergency because of fluid, I put on two stone in fluid in a 12 day period which was affecting by breathing very badly ( a lot of fluid in my abdomen). Fluid was drained and even after two days felt much better. With all this I did not have pain or could I feel that my heart was going like the clappers. I was kept in for 11 days and had tests galore. I remember the staff nurses forever asking are you in any pain, seem to be very few hours, but I was not and kept telling me I was very ill, but I did not feel that ill. So I think I have had AF for some time, years but not really noticed it.

  • I really feel for you B. I am like yoy in that every irregular heartbeat is very palpable for me and sometimes I experience pain too. We all must be so unique. i wish I were one of the ones who does not feel it as my quality of life would be so much better. I hope things have eased for you since this post was written.

  • It definitely seems that we are all so different . I am in persistent AF and have never felt anything leaping or banging around in my chest . I did not know I had it when in October 2013 I went to the doctors after feeling tired , bloated , no energy, breathless,

    , v swollen ankles and just unwell for several days , he told me there and then I had AFib and sent me to hospital to be checked over . 2 hours later I had a stroke . they drained 6 kilos of fluid from my chest and stomach . long story short , I still feel mild flutters now and then but that's about it


  • G'day,

    Well just to toss my views on the pile - when I was discharged from Hospital back to the care of my GP my Cardio Cons. wrote, unmistakably, 'could be in AF and not be aware' ! The nature of the diagnosis has a part to play too I think. In my case my GP shoved me off to A & E, diagnosed within 9 hours of onset, kept in hospital for 6 continuous days while shedloads of tests were done thus giving the team every opportunity to fully assess me.

    During the first 4 months after diagnosis I was very often aware of my AF; several squadrons of butterflies in a perpetual dogfight in my chest, several mobs of octupuses wriggling away in my chest, or armies of ants going for it in my chest - and at times going so cold that I felt I was visiting a very, very, 'dark' place and I actually felt that this is what it would be like to die. Used to take 30 or 40 minutes to walk distances I can now do in 10.

    Long story short - over and above medication I self treated with the aid of a nutritionist and changed my diet because I felt my AF came from a dysfunctional vagal nerve - details of which I gained from the old (now long defunct) AFA forum. I would never admit to being cured. I do believe it is now so well controlled that I don't think it will come back - but - given my Cardios comments one can never be sure.

    Apart from politicians - AF is the most untrustworthy thing I have encountered in my life, and I have not led a sheltered life ! I was blessed with a great medical team in the beginning and now I have learned and continue to learn about this mongrel condition I feel so sorry for those sufferers who are less fortunate than I.

    Now 5 years later aged 70 am just fine, still working 3 or 4 days a week and as active as ever.


  • Hi John,

    Could you expand on the nutritional information?


  • Bit of a story Gary,

    Some 4/5 months after diagnosis I began to associate the onset of an AF event with food and digestive issues. Seems that a dysfunctional vagal nerve is recognised as a contributor here. Vagal Nerve controls both the digestive system and heart. My symptoms were massive and painful bloating, burping, diahorrea and intestinal gurgling. The cause a wide range of foods. Saw my GP at the time who had tests done for IBS and Coeliac Disease - all clear. I then went and saw a Nutritionist who put me on probiotics - VSL #3. Then suggested that I go gluten and wheat free and look at following FODMAPS diet. I found this too hard but picked the eyes out of it. Range of foods I now avoid is amazing - no peas, no long green beans, no nuts, no real ales, limited lagers, no raspberries, very little pastry, no gravy or gluten free gravy, no oats or wheat products, - the list goes on. No bread. No cabbage,

    No pork or crackling, Fish Ok, most other meats OK, chicken Ok - but every now and then I eat something which upsets me ! Hope this helps.


  • I also have asked the same question I have had AF for 4years & boy do I know when I have an episode. Can I ask anyone when they have an episode ofAF when they go back into sinus rhythm hVe they passed out, it happened to me, I got up out of my chair felt dizzy passed out for a few seconds. Which resulted in a 2day stay in hospital. Now on double dose of Flecinide.

  • I had a heart rate of 180-I didn't feel it! I just felt very dizzy and blurred vision,my husband had his stethoscope handy and listened to my heart,called an Ambulance, I was hospitalised do 9 days,unfortunately we were in Tenerife ,I had the shock treatment 3days later which worked for two days before relapsing then I was put on drugs

    Brilliant treatment in Tenerife ,still awaiting an appointment with a Cardiologist here at home!

  • Not sure about two sparrows more like two dogs in my case!

    Yes I have always been at a loss to understand why some people are not aware of their AF. When I was waiting for my pre op assessment for my PVI I got talking to another person who stated she only found out when she was having other checks for something unrelated!.

    However I have thought hard and long about this as well as searching and reading posts in this forum.

    I was told by my EP that one doesn't feel the left atria fibrillating. When in sinus rhythm its the b of the b DUM. On checking one's pulse when in sinus its easy to feel the DUM but not the b. This DUM is the left ventricle beating and is a lot more powerful as it has to pump blood around the body and not just between the atria and the ventricle that the atria is responsible for.

    So what is it that is felt when in AF? This is what is called SVT or supra ventricular tachycardia. In sinus rhythm the atria fires first via the sinus node and this electrical wave is held up for a split second by the SV node, ie it is acting like a gate to stop the wave from contracting the atria and the ventricle simultaneously thereby creating the b DUM. When in AF the chaotic signals that cause the atria to fibrillate 'confuse' the SV node and is overloaded leading to erratic firing of the ventricle contractions. It is this erratic ventricle response that gives rise to SVT and the two sparrows fighting in one's chest feeling.

    Perhaps , just speculation here, some people whilst in AF don't get such a an overload on the SV node and don't suffer the SVT in such a chaotic manner and are therefore not symptomatic.

    If one is therefore not symptomatic and you can't actually feel that the atria may be fibrillating you may very well be unlucky in the sense that if you can't feel it the first time you know about it is when there is a thrombic event.

    But this is only my thoughts but as an AF sufferer for 8 years before ablation I had plenty of thinking/research time.

  • Thanks Jumper! This is the reply I really wanted-someone else's theory.

    Glad your ablation worked-I hear some horror stories!

  • I must have written my original reply as a 'stream of consciousness' going straight to my fingers and missing my brain. SV Node should have read AV Node. There is no such thing as an SV node. Sorry for my Duuurrrr brain.

  • I totally relate to this post boberch as I feel my daily episodes very acutely and can actually feel when my heart is 'trying' to get into AF if that makes sense. I fins arrythmias challenging and the physical symptoms most unpleasant when I am in them. i hope you are a bit better since this post was written:)

  • I know what you mean by 'trying' - a little hiccup here- a jolt there- a feeling of chesty uncertainty :-)

  • I've never felt any symptoms. No breathlessness, no dizziness, no palpitations, no headaches, no oedema, nothing....

  • Blimey-In some ways that is amazing and a good thing. In other ways it could be dangerous; in a patient undiagnosed, as they may go on to a stroke.

  • I felt nothing and did not even know what AF was. 2 years ago after a sleepless week and a long day at work I unknowingly "fainted"? I was 67

    I "woke up" in the ambulance... I was connected up to an ECG! The medic told me I had AF! This meant nothing to me. The doctors at the hospital thoroughly checked me out and confirmed the diagnosis.

    I had several appointments with Specialists to be assessed. I had all sorts of testing and monitoring and ECGs. The diagnosis was permanent AF! Apixaban plus Bisoprolol was prescribed.

    Now I know what AF is but can't feel anything, except I know something is wrong when I feel my pulse! I had noticed my irregular pulse years ago, but had not been worried about it.

    Cardioversion was suggested but because of the probable time I had AF and lack of symtoms, it was decided not to go ahead.

    My point is that I 've noticed that whilst having had my blood pressure checked over the years, lately my pulse was no longer checked? This might have shown up my heart issue!

    I was lucky to be checked over by the ambulance crew at the age of 67.

    Now I am on medication

    How many people are unaware of having AF until it's too late

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