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What is atrial fibrillation (A-fib)?

Atrial fibrillation is a kind of arrhythmia (abnormal heartbeat) that affects almost five million Americans. It often originates in the left atrium, the upper left chamber of the heart. When atrial fibrillation occurs, the upper chambers of the heart beat in an unorganized rhythm, and the heart rate may increase from the normal range of 60 to 100 beats per minute to 150 to 200 beats per minute. The condition can lead to chronic fatigue and can increase the chances of congestive heart failure or stroke.

Watch the Atrial Fibrillation Virtual Patient Symposium to hear from experts about treatment options for A-fib and the specialized care provided at the Brigham.

What are the risk factors for A-fib?

Risk factors can include:

  • Heart disease
  • Hypertension (high blood pressure)
  • Obesity
  • Drinking alcohol
  • Sleep apnea

What are the symptoms of A-fib?

You may experience one or more of the following:

How is A-fib diagnosed?

Along with a careful physical examination, your cardiologist may order one or more of the following tests or procedures:

Blood tests help determine whether there are substances in the bloodstream that are contributing to atrial fibrillation.

What are the treatment options for A-fib?

Our program offers state-of-the-art atrial fibrillation treatment and comprehensive cardiovascular care in a world-class medical facility. It is important to treat atrial fibrillation promptly, because the condition can worsen over time as the heart muscles weaken, making it even more difficult for the atria to function properly.

Specialists from the Cardiac Arrhythmia Service develop individualized treatment plans for patients based on:

  • Age
  • Overall health
  • Medical history
  • Severity of the disease
  • Tolerance for specific medications or procedures
  • Expectations for course of the disease
  • Presence of other conditions

Treatment may involve a number of options (below).

What medications are prescribed for A-fib?

Anticoagulant medications (blood thinners) are used to prevent the blood clots that can form due to atrial fibrillation and can lead to stroke.

Antiarrhythmics help to keep the heart in normal rhythm.

Watch this video What You Need to Know about Anticoagulant Therapy with Gregory Piazza, MD.

Do you offer ablation for A-fib?

We offer a variety of treatments, including Catheter ablation (cardiac ablation). Other treatments include:

  • Cardioversion - During brief sedation administered by an anesthesiologist, this procedure delivers an electrical current through the chest wall to the heart through special electrodes or paddles that are applied to the skin of the chest and back. The purpose of the cardioversion is to interrupt the abnormal electrical circuit(s) in the heart and to restore a normal heartbeat. The delivered shock causes all the heart cells to contract simultaneously, thereby interrupting and terminating the abnormal electrical rhythm without damaging the heart. The heart’s electrical system then restores a normal heartbeat.
  • Implantable cardioverter defibrillator (ICD)
  • Pacemaker implantation
  • Transvenous lead extraction

What if I need surgery for A-fib?

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Watkins Clinic for pre-operative information and tests. The day of surgery, your care will be provided by surgeons, anesthesiologists and nurses who specialize in surgery for patients with atrial fibrillation. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center. Staff members will provide surgery updates and caregivers who leave the hospital will be contacted by cell phone.

Download Cardiac Surgery: A Guide for Patients (English)

Download the Cardiac Surgery: A Guide for Patients (en Espanol)

How do I request an appointment or find directions?

The Cardiac Arrhythmia Service at the Brigham and Women’s Hospital Heart & Vascular Center is devoted solely to the care of patients with irregular heart rhythms, heart palpitations and rapid heartbeat conditions, such as atrial fibrillation.

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from the Brigham's main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

Why choose the Brigham?

Exceptional and Compassionate Care

At Brigham and Women’s Hospital, our atrial fibrillation specialists provide expert evaluation and diagnosis with the aid of the latest in advanced imaging technologies. Treatment is provided by some of the world's most experienced physicians in cardiac electrophysiology (the study of the heart’s electrical system). Together, they perform more than 3,000 procedures annually, utilizing the latest medications, devices and innovative care approaches. We offer patients personalized care and expertise that includes ongoing communication and education throughout treatment, outpatient care and follow-up.

Collaborative Care

Patients benefit from the teamwork of cardiologists, interventional cardiologists, cardiac surgeons, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in atrial fibrillation. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients. Learn about our Heart & Vascular Team.

Do you have additional resources on A-fib?

Watch the Living with Atrial Fibrillation video with Julie Shea, NP, discussing atrial fibrillation diagnosis, treatments and research.

Learn more about atrial fibrillation in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center where patients and families can access computers and knowledgeable staff.

Access a complete directory of patient and family services.


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