Atrial Fibrillation (AFib) - Diagnosis & Treatment

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How is atrial fibrillation diagnosed?

Diagnosing AFib starts with a physical examination and a review of your symptoms and medical history. Because AFib can come and go, further tests are often needed to confirm the diagnosis and understand its pattern:

Electrocardiogram (ECG): Records the heart's electrical activity and is the primary way AFib is confirmed, but only if performed during an active episode.
Holter monitor or event monitor: A portable ECG device worn for days to weeks, used to capture intermittent episodes that a standard ECG might miss.
Echocardiogram: Uses ultrasound to assess the heart's structure and function, and to check for underlying valve disease or other structural causes.
Blood tests: Used to check thyroid function and other factors that may be contributing to the arrhythmia.

Can a smartwatch or fitness tracker detect atrial fibrillation?

Many modern smartwatches and fitness trackers include features that can flag an irregular heart rhythm suggestive of AFib, and these alerts have led an increasing number of patients to seek medical evaluation. However, these consumer devices are a screening tool, not a diagnostic one – a wearable-device alert should always be confirmed with a medical-grade ECG and clinical assessment, since irregular readings can also result from other causes.

How is atrial fibrillation treated?

Treatment for AFib is generally guided by three goals: controlling the heart rate, restoring or maintaining a normal rhythm where appropriate, and reducing stroke risk. The right combination depends on the type and duration of AFib, symptoms, and overall health.

Rate and rhythm control medications

Rate-control medications slow the heart rate without necessarily restoring a normal rhythm, and are often the first step for many patients. Rhythm-control medications (antiarrhythmics) aim to restore and maintain a normal heart rhythm, and may be used alongside other treatments or after a procedure such as cardioversion or ablation.

Blood thinners and stroke prevention

For most people with AFib, reducing stroke risk is just as important as managing the rhythm itself. Blood-thinning medication (anticoagulants) is commonly prescribed to reduce the risk of clot formation, with the specific recommendation based on an individual stroke-risk assessment rather than a one-size-fits-all approach.

Cardioversion

Cardioversion aims to restore a normal heart rhythm, either using controlled electrical shocks delivered under sedation (electrical cardioversion) or through medication (chemical cardioversion). It is often used for persistent AFib or when rhythm control is the preferred approach.

Catheter ablation for atrial fibrillation

Catheter cardiac ablation is a minimally invasive procedure that targets the specific area of heart tissue – usually around the pulmonary veins – responsible for triggering AFib. A catheter is guided into the heart through a blood vessel, and energy is delivered to create small, precise scars that block the abnormal electrical signals from spreading. This is generally considered when medication alone does not adequately control symptoms, or as an earlier option for suitable patients.

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