Understanding Atrial Fibrillation (AFib)

Atrial fibrillation (often called AFib) is a common irregular heart rhythm condition in older adults. While AFib itself is not always life-threatening, it significantly increases the risk of stroke if not properly managed.

AFib can lead to stroke, heart failure, blood clots, and other cardiovascular complications.

With the right combination of medication, lifestyle habits, and monitoring, many people with AFib live full, active lives.

What Is Atrial Fibrillation?

AFib occurs when the upper chambers of the heart (the atria) beat irregularly and too fast. Instead of pumping blood smoothly, the heart quivers, which can allow blood to pool and form clots.

If a clot travels to the brain, it can cause a stroke.

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Why AFib Is More Common in Older Adults

Your risk of AFib increases if you:

• Are over age 65
• Have high blood pressure
• Have heart disease or heart failure
• Have diabetes
• Have sleep apnea
• Have had a prior stroke or TIA
• Have other chronic medical conditions
• These are only some of the risk factors for AFib - Learn more about AFib causes and risk factors here: National Heart, Lung, and Blood Institute 

Many people with AFib have no symptoms, which is why diagnosis and treatment are so important.

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Common Symptoms of AFib

Some people feel symptoms, while others do not.

AFib Symptom Checklist

☐ Irregular or rapid heartbeat
☐ Heart palpitations (fluttering or pounding)
☐ Shortness of breath
☐ Fatigue or low energy
☐ Dizziness or lightheadedness
☐ Chest discomfort
☐ Reduced exercise tolerance

⚠️ Symptoms may come and go — even without symptoms, stroke risk can remain.

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Why Stroke Prevention Is Critical

AFib increases stroke risk because blood clots can form in the heart. Stroke prevention is the a critical part of AFib management, especially in older adults.

Your healthcare provider assesses stroke risk using your age, medical history, and other factors — not just how you feel.

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Anticoagulants (Blood Thinners): What to Know

Anticoagulants reduce the risk of stroke by preventing clots from forming.

Common Types of Anticoagulants

• Direct oral anticoagulants (DOACs), such as apixaban (Eliquis) or rivaroxaban (Xarelto)
• Warfarin (Coumadin)

These medications do not treat the heart rhythm, but they work to lower stroke risk.

Important Safety Tips for Anticoagulants

✔ Take exactly as prescribed
✔ Do not skip doses
✔ Tell all healthcare providers you are on a blood thinner
✔ Ask before starting new medications or supplements
✔ Watch for signs of bleeding

🚨 Call your provider if you notice unusual bruising, bleeding, black stools, or blood in urine.

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Lifestyle Strategies That Support AFib Management

Healthy habits work alongside medication to reduce complications.

Heart-Healthy Lifestyle Tips

• Work with your healthcare provider to control blood pressure
• Stay physically active (as approved by your healthcare provider)
• Maintain a healthy weight
• Limit alcohol
• Avoid smoking
• Manage stress
• Treat sleep apnea if present

💡 Small, consistent changes can improve heart health and overall well-being.

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AFib Monitoring Checklist

Track changes and share them with your provider:

☐ Heart rate or rhythm changes
☐ New or worsening symptoms
☐ Missed medication doses
☐ Side effects from medications
☐ Blood pressure readings (if monitored)
☐ Falls or bleeding events

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AFib & Stroke Prevention Action Plan

My AFib Health Goals

• I will take my AFib medications daily as prescribed
• I will track symptoms ___ days per week
• I will monitor my blood pressure if recommended
• I will limit alcohol intake
• I will attend follow-up appointments

Emergency contact: _______________________

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When to Seek Medical Help

Contact your healthcare provider if you experience:

🚨 New or worsening AFib symptoms
🚨 Frequent dizziness or fatigue
🚨 Signs of bleeding
🚨 Medication side effects
🚨 Difficulty managing medications

Seek emergency care immediately if you have:

• Sudden weakness or numbness (especially on one side)
• Trouble speaking or understanding speech
• Vision changes
• Severe headache
• Chest pain or shortness of breath

Call 911 — these may be signs of stroke or heart emergency.

Always ask your healthcare provider for specific advice on when to call to report symptoms, and when to seek urgent/emergency care.  

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Key Takeaways

• AFib is common and manageable in older adults
• Stroke prevention is the main treatment goal
• Anticoagulants significantly reduce stroke risk
• Lifestyle habits support heart and brain health
• Tracking symptoms improves safety and care

Managing AFib is about protecting your heart, brain, and independence.

Learn more about Atrial Fibrillation from:

• National Heart, Lung, and Blood Institute
• CDC
• American Heart Association

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Medical Disclaimer

This information is provided for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a qualified healthcare professional. Atrial fibrillation and chronic medical conditions vary from person to person, and treatment plans should be individualized.

Always consult your physician, nurse practitioner, cardiologist, or other licensed healthcare provider regarding symptoms, medications (including anticoagulants), lifestyle changes, or concerns related to AFib. Do not delay or avoid seeking medical care based on information in this resource.

If you experience symptoms of stroke, chest pain, severe shortness of breath, or sudden changes in mental status, call 911 or seek immediate medical attention.

Sources:

• UpToDate