Tip Sheet: Living with Atrial Fibrillation

Atrial fibrillation is a type of irregular heartbeat that is often rapid. It is a common kind of arrhythmia–a condition in which your heart beats with an abnormal rhythm. However, many older people with atrial fibrillation don’t have any obvious symptoms. Atrial fibrillation can be intermittent (occurs on-and-off) or chronic (present all the time).

Common Symptoms Common Causes
  • Palpitations
  • Racing or fluttering of the heart
  • Shortness of breath
  • Chest discomfort
  • Lightheadedness and dizziness
  • Weakness or tiredness
  • Anxiety
  • High blood pressure
  • Prior heart attack
  • Sleep apnea
  • Heart valve problems
  • Other heart disorders

The risk of atrial fibrillation increases with age, and it is present in about 10% of people 80 years of age or older. It is somewhat more common in men than in women. It is also more common in people with overactive thyroid, sleep apnea, emphysema, and other lung diseases. Atrial fibrillation is a leading cause of strokes in older adults.

Here’s what the experts at the Health in Aging Foundation recommend:

Get regular check-ups. If you have atrial fibrillation, it is important to see your healthcare provider regularly. Discuss any new symptoms or if your treatment isn’t controlling your symptoms. If so, the provider can change your treatment to help you feel better.

Take your medicines as prescribed. Medicines for atrial fibrillation work to keep the heart rate under control, reduce symptoms, and decrease the risk of stroke. In order to work properly and provide the greatest protection, medicines must be taken regularly and according to the instructions. Ask your healthcare provider if you have any questions.

Learn the warning signs of stroke.

Because atrial fibrillation can increase your risk of having a stroke, it is very important that you recognize the warning signs. You can use the FAST guideline to remember the most common symptoms to look out for.

  • FACE: Sudden drooping of one side of the face
  • ARMS: Sudden numbness and weakness in one arm
  • SPEECH: Sudden slurred or garbled speech or difficulty finding words
  • TIME: If you see any symptoms of stroke, call 911 immediately.

There are also less common signs of stroke. Even though they are less common, you should still call 911 immediately for these symptoms as well.

  • Sudden difficulty with balance or coordination
  • Sudden loss of vision, blurred vision, or double vision
  • Severe headache
  • Sudden confusion or change in level of awareness
  • Sudden confusion

Engage in physical activity. Regular activity such as walking and cycling can make your heart stronger and lower your risk of heart problems. It can also help you lose extra weight–a healthy weight is an important part of managing atrial fibrillation. Work with your healthcare provider to come up with an exercise plan that will be safe, effective, and enjoyable.

Quit smoking and avoid excess alcohol. The nicotine in tobacco can increase your risk for atrial fibrillation. Smoking also damages the heart and lungs and increases the risk of cancer. If you smoke, quitting is one of the best things you can do for your health. If you need help quitting, talk to your healthcare provider.

For some people, alcohol can increase the risk of atrial fibrillation, especially if you drink large amounts.

If alcohol triggers your atrial fibrillation, you should avoid it completely.

Talk to your pharmacist or healthcare provider. Ask your pharmacist or healthcare provider BEFORE you take a new prescription, over-the-counter drug, herbal medicine, or other supplement. They can tell you about possible side effects and interactions with other medications you are already taking.

If you are taking warfarin, be careful about eating certain foods. This medication (also known by its brand name, Coumadin®)  decreases the risk of stroke by making your blood less likely to form clots. (Warfarin is sometimes referred to as a blood thinner, but it does not actually thin the blood.)

Some foods can make warfarin stronger or weaker, especially certain vegetables and vegetable oils that are high in vitamin K. Examples are lettuce, cabbage, broccoli, and other greens. These vegetables are good for your health, so don’t skip them. However, changing how much of these vegetables you eat can interfere with warfarin and increase the risk of stroke or bleeding. Instead, try to eat a similar amount on a regular basis and talk to your healthcare provider about how you can eat them safely.

Alternatives to warfarin.  Recently, several new medications for preventing strokes in people with atrial fibrillation have become available. These include dabigatran (Pradaxa®), rivaroxaban (Xarelto®), apixaban (Eliquis®), and edoxaban (Savaysa®). These medications are at least as effective as warfarin in preventing strokes and may be associated with a lower risk of serious bleeding.  They also have fewer interactions with other medications compared to warfarin and they don’t require blood tests for monitoring. However, none of these drugs are available as a generic, so the cost is usually higher than for warfarin.


Last updated August 2019


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