A flutter, a racing pulse or a smartwatch alert can all point to AFib. Here's what atrial fibrillation feels like, why it raises stroke risk and how it's found.
It often starts as a strange flutter in the chest while you’re watching TV, or a heartbeat that suddenly feels fast and out of step after a glass of wine. Some people feel short of breath walking to the mailbox. Others feel nothing at all and only find out when a smartwatch sends an alert or a routine EKG shows something unexpected. That heart rhythm problem is often atrial fibrillation, better known as AFib, and it is one of the most common reasons adults in Palm Beach County end up talking with a doctor about their heart.
In brief
- AFib is an irregular, often fast heart rhythm that starts in the heart’s upper chambers. Some people feel it, many don’t.
- The biggest concern is stroke, which is why an irregular pulse or a smartwatch alert deserves a proper check.
- An EKG confirms it, and treatment focuses on lowering stroke risk and controlling the heart rate or rhythm.
What is atrial fibrillation?
Your heart has four chambers. In a normal rhythm, an electrical signal starts in the upper chambers (the atria) and travels in an orderly way to the lower chambers (the ventricles), producing a steady, regular beat.
In AFib, the electrical signals in the atria become chaotic. Instead of squeezing firmly, the upper chambers quiver. The lower chambers receive a jumble of signals and beat irregularly, often faster than normal. AFib is the most common type of heart arrhythmia in adults, and it becomes more common with age.
Doctors usually describe AFib by how it behaves over time:
- Paroxysmal: episodes come and go, often stopping on their own.
- Persistent: the irregular rhythm lasts longer and usually needs treatment to restore a normal rhythm.
- Long-standing or permanent: the rhythm stays irregular, and treatment focuses on controlling the heart rate and preventing complications.
Common AFib symptoms
AFib does not feel the same for everyone. Some people notice every episode; others have it for years without a clue. When symptoms do appear, they can include:
- A fluttering, pounding or “flip-flopping” feeling in the chest (palpitations)
- A heartbeat that feels fast, irregular or out of rhythm
- Unusual tiredness or feeling wiped out after normal activity
- Shortness of breath, especially with exertion or when lying flat
- Lightheadedness or dizziness
- Reduced ability to exercise
- Chest discomfort or pressure
Because fatigue and breathlessness are easy to blame on age, heat or a bad night’s sleep, AFib is often missed until someone checks the pulse or runs an EKG.
When it is an emergency
Call 911 right away for chest pain or pressure, fainting, severe shortness of breath, or any signs of a stroke. A simple way to remember stroke signs is BE FAST: sudden loss of Balance, trouble with the Eyes or vision, Face drooping, Arm or leg weakness, Speech that is slurred or confused, and Time to call 911. Do not drive yourself.
Worried about a fluttering heartbeat?
At Wave, you can see your own doctor the same or next day, with an EKG and cardiology right in our Boynton Beach building. Come in for a free tour and consultation.
Why AFib matters: the stroke connection
The irregular beat itself is usually not the main danger. The bigger concern is what happens inside the quivering upper chambers. When blood isn’t pumped out efficiently, it can pool and form clots. If a clot travels to the brain, it can cause a stroke. People with AFib have a significantly higher risk of stroke than people with a normal rhythm.
Over time, a heart that beats too fast for long stretches can also become weaker, which may lead to heart failure. The good news is that both risks can be lowered considerably with the right evaluation and follow-up.
Who is more likely to get AFib?
Anyone can develop AFib, but certain factors raise the odds:
- Older age
- High blood pressure, which is one of the most common contributors
- Coronary artery disease, heart valve problems or a past heart attack
- Heart failure
- Diabetes
- Obstructive sleep apnea
- Overweight and obesity
- An overactive thyroid
- Heavy alcohol use, including binge drinking
- A family history of AFib
Many of these are things a primary care doctor already watches. Keeping blood pressure and cholesterol under control, treating sleep apnea and limiting alcohol are part of lowering the risk of AFib episodes.
How AFib is diagnosed
AFib is confirmed with an electrocardiogram (EKG), a quick, painless test that records the heart’s electrical activity through small sticky pads on the chest. If episodes come and go, a single EKG may look normal, so a doctor may suggest a wearable monitor that records your rhythm for days or weeks.
Other tests help find the cause and guide treatment:
- Blood work to check thyroid function, blood counts, kidney function and other factors.
- An echocardiogram, an ultrasound of the heart that shows its size, pumping strength and valves.
- A stress test in some cases, to look at how the heart handles exertion.
What about smartwatch alerts?
Many smartwatches can flag a possible irregular rhythm. That alert is a good reason to check in with a doctor, but it is not a diagnosis. Watches can miss AFib and can also raise false alarms. Bring the readings to your appointment, and let a proper EKG settle the question.
How AFib is treated
Treatment is tailored to each person, but it generally has three goals:
- Lowering stroke risk. Doctors use a standard scoring approach based on age and other health conditions to decide whether a blood thinner is recommended.
- Controlling the heart rate so the heart doesn’t race, usually with medication.
- Restoring or keeping a normal rhythm when appropriate, with medication, a procedure called cardioversion, or catheter ablation performed by a heart rhythm specialist.
Treating the conditions that feed AFib, such as high blood pressure, sleep apnea, diabetes and excess weight, is an important part of the plan. Only your doctor can decide which approach fits you.
The usual way vs. having your own doctor
AFib is a condition where quick access and good coordination make a real difference. Here is how a few common situations tend to play out.
The smartwatch alert. The usual way: you get an irregular rhythm alert on a Saturday, can’t reach your doctor’s office, and either worry all weekend or spend hours in an emergency room waiting area. With a concierge doctor: you text your own doctor, who knows your history, asks the right questions and tells you whether to come in, wait or call 911.
Getting the tests done. The usual way: an EKG at one office, a referral for an echocardiogram weeks later at another location, and blood work somewhere else, with results scattered across portals. At Wave in Boynton Beach: blood work, EKG and ultrasound are in the same building, and cardiology is on location, including stress tests.
Seeing the specialist. The usual way: a long wait for a cardiology appointment, then repeating your story from scratch. With your own doctor: a concierge liaison handles the booking and paperwork, records are sent ahead, and your doctor reviews the results with you afterward so nothing falls through the cracks.
Many people with AFib, whether they live in Boynton Beach, Delray Beach or Boca Raton, also take several heart and blood pressure medications. Wave keeps one up-to-date medication list and sends prescriptions to your nearest pharmacy, which matters with drugs like blood thinners. You can learn more about how we handle ongoing conditions on our chronic disease management page, and if you track your numbers at home, our guide on how to check blood pressure at home is a good place to start.
Your heart deserves a doctor who picks up
Wave members can call, text or video their own doctor 24/7, weekends included. We accept Medicare and most insurance. Visit our Boynton Beach office for a free, no-obligation consultation.
The bottom line
AFib is common, often quiet and very manageable once it’s found. If you’ve noticed a fluttering or racing heartbeat, unexplained tiredness or breathlessness, or your watch keeps flagging an irregular rhythm, don’t brush it off. A simple EKG and a conversation with a doctor who knows you are the right first steps.
This article is general information, not medical advice for your situation. For a medical emergency, call 911.
Read next
