Confused - what exactly is AF?: I'm wondering... - AF Association

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Confused - what exactly is AF?


I'm wondering what exactly is AF? I was diagnosed just a couple of months ago and put on Pradaxa and Bisoprolol. I have in the past had a few scary episodes when my heart rate varied between very rapid and slow thumpy beats. But I quite frequently got a simple raised heart rate, occasionally associated with some irregularity. I still get this sometimes, tho' the rapidity is reduced now because of the medication.

Which of these can be described as an AF episode? When would a medical opinion be indicated?

I have been lurking on this site for a week or two and have learnt a lot - much more than I have got from the doctors! Thank you everyone.

11 Replies

Welcome and glad you have posted!!!

AF these days is defined as when the left atrium is beating irregularily. There is a wealth of information that is easy to read on the main AFA website. You can read the data sheets or booklets online or print them off or download them or ask for printed copies to be sent.

There is no clue as to your age and any other health issues. Glad you are on Anticoagulation since us AFers are over 5 times more likely to have a stroke.

You don't say who diagnosed you nor if you have seen a specialist. If not then I would urge you to get a referral to an EP (Electrophysiologist) since they are cardiologists who specialise in arrythmia (in laymans terms the electricians of the heart).

Please feel free to ask questions and if you don't want something to appear on the forum you can always PM (private message) people - almost all don't mind though you can always send them a pm first saying can you ask them a question.


Atrial fibrillation is when the left atrium instead of contracting in an orderly fashion fibrillates or pulsates. It has been described as like a bag of worms.

Since each chamber of the heart interacts with the others. this makes the ventricle, the bit that actually pumps blood round your body. rather confused so it in turn beats in an irregular fashion. This means that the blood may not be pumped as efficiently and some people feel dizzy or confused during events with some even fainting. The actual rate is variable and while some people may experience extremely high heart rates up to and even above 200 beats per minute ( BPM) some may only be in the low hundreds or even lower. It is the irregularity with no effective rhythm which matters. By the way, AF is quite easy to see on an ECG trace but I wont confuse you by trying to explain why.

Many sufferers are actually asymptomatic and unless found by accident are quite unaware of the condition and it is those who are most at risk since as Peter mentions AF makes us five times more at risk of stroke. Once anticoagulated those people are the lucky ones since they are not troubled by the panic and distress that events induce on those with paroxysmal AF (comes and goes).

Regarding seeking help should events occur it is generally accepted that if you have any chest pain or dizziness/fainting then a trip to A and E or your doctor is in order . You will learn how to cope and what to do (rest usually) in other circumstances.

As Peter suggests do go to the main website and read all you can as knowledge is power.

If you have not already seen a specialist then do consider asking to see one as general practitioners, cardiologists and A and E doctors are seldom as well educated as many people on here where AF is concerned.

in reply to BobD

@PeterWH Ple4ase find the most experienced, qualified, educated electrophysiologist you can. Research the person's education, research, published studies, teaching at a medical school etc.-he should be in a hospital where no bad side effects during the ablation procedure has occurred and he needs to have done a great number of ablations. then get copies of any of your arrythmias as per ekg and any dr. reports and bring or fax it to him. Can you refer yourself using these items as evidence that you need to see an EP--waiting for a referral seems somewhat anxiety producing and possibly dangerous. In the USA the 3 best places for this are: Mayo Clinic-Rochester Minnesota; Cleveland Clinic, Ohio; Stron Memorial Hospital in Rochester NY. If $ permits, you might get better treatment there. Do a computer search for info:

what things trigger afib (there is a huge list)? Mine are caffeine, alcohol, sugar , salt, quinolone antibiotics, nsaids, large macrolide antibiotics like biaxin and azithromax, excessive heat exposure, not enough sleep, not eating enough protein, processed foods, allergens., low levels of macrominerals like magnesium and potassium, micro/trace minerals; eloectrolyte imbalances ( certain rx. drugs--even the ones' taken for afib actually cause depletion of all these nutrientsplus also co q10, which your heart needs to function normally). It is really a complex issue.

Welcome to the forum Jay. AF is the chaotic, fast beating of the upper chambers of the heart, causing some of these beats to be transferred down to the lower pumping chambers also in a chaotic manner. Your pulse, coming from the lower chambers will feel uneven - slow and fast but not regular.

Sometimes AF is accompanied by other electrical disturbances - ectopics which cause an apparent pause followed by a great thump and tachycardia which is a fast but regular heartbeat. As you learn more about the condition, you'll be able to tell one from the other, if you need to. Peter's advice is good - read, read and read but do remember that not everything applies to everyone. Each of us has our own version of AF and reacts differently to symptoms and drugs.

As everyone says - it doesn't kill you, it just feels like it will and anticoagulation significantly reduces the stroke risk. Feel free to post away and ask questions - finding this forum is a big step in understanding - and therefore coping. Best wishes

Just read the replies by the others and though an example would be useful.

I am in persistent AF. I use an electronic device called a Kardia AliveCor to take my pulse twice a day. I sit at a table for circa 10 mins so the two minute readings on different days are more comparable.

Yesterday morning over the two minutes it recorded average HR 118 (during a mini event) and HR ranged from 57 to 151 (diff 94). Then 30 mins later AV HR 84 with HR 65 to 115 (diff 50). Then 4.5 hours later still AV HR 75 with HR 58 to 88 (diff 30). Normally the diff is around 40 to 50. A normal person would gets diff of say 10.

All useful info above - now a more lighthearted explanation of what AF is - hope it brings a smile

in reply to CDreamer

Loved it thanks

The raised heart rate with irregularity is AF. The quick/slow beats would probably be tachybrady syndrome. Obviously I say this without being medically qualified or seeing an ECG!

I asked the second question recently when seeing a consultant about another condition and she simply said, 'If you don't feel well!'

There is still a lot of uncertainty about all of this. Reading on line forums can be scary as each of us is different and with two million or possibly many more with this condition it is easy to become more scared than you need to. I have written on here before and my situation seems very different as are the views of the top specialist here in Essex. Mine was discovered whilst about to go down for a replacement knee op which was cancelled. Following six months of various cardio tests which showed no other faults I successfully had the surgery six weeks ago. I still have AF episodes every couple of weeks that last 24 hours or so. They have little effect on me other than possible feeling a bit light headed or slightly breathless. Heart rate goes up to about 90 at first then runs in uneven groups of beats at about 80 bpm.

I am at risk 1(based on being 66, no other factors) on the CHAD score and have been shown quite clearly by the consultant on the computer that this raises my stroke risk from 1 in 150 to 1 in a hundred. So yes, you can call that 50% increase for me. The view of the consultant is that I am in a marginal situation in that if I was in Europe they would say no need but if in the US it would be recommended. So basically left up to me which makes for a difficult decision. yes - some reduction in risk but also a slight increase in risk of a brain bleed. Also if Warfarin a change in lifestyle required although probably not much in my case. So it's up to me really!

All i would say is there are probably millions of people either unaware of the condition or not bothered and leading normal lives. This does not mean there aren't also a large number for whom this condition is very serious in terms of how they are affected so I would not trivialise it and have every empathy with. Them so I am really saying you need to get as much information about YOU and base what you want to do on that without worrying about what is happening to other people.

Good luck,


My thanks to everyone who has replied to my post. All your answers are very helpful and encouraging. It's the lack of knowledge that is the worrying factor, and I feel much more positive now.

CDreamer, I loved the video!

in reply to JayDW

I agree, lack of knowledge is not good, I'm still in a quandary not knowing what my heart is doing, it seems to be getting more persistent now too, so all the above posts are invaluable.

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