First signs and symptoms of atrial fibrillation

Atrial fibrillation (AF) is a heart condition in which the heart rate is irregular and the pulse rate is faster than normal. People may experience symptoms such as palpitations (a noticeably rapid, strong or irregular heartbeat), dizziness, breathlessness and tiredness. Sometimes people have no symptoms at all.

We asked Dr Tim Holt, an academic GP, to explain what AF is, and to describe its symptoms.

Dr Tim Holt explains how people with AF have an irregular heartbeat. They may experience symptoms such as palpitations or have no symptoms at all.

Gender Male

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In our interviews people talked about the way they first experienced AF. For some, the first episode of AF occurred “out of the blue” while they were going about normal everyday activities. Some needed to urinate frequently, others had a dizzy spell at work or experienced symptoms such as palpitations while sitting quietly watching television.

Eileen explained how she woke up one morning and discovered she “couldn’t stand up long enough to cook breakfast”.

George X collapsed in town.

David X had an “out of body experience” and “strange, floating sensations” while driving.

Martin, whose sister has AF, had an inkling’ he might have it too when he had palpitations walking home.

Age at interview 73

Gender Male

Age at diagnosis 71

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After experiencing palpitations and dizziness one morning, Pauline spent three days in hospital.

Age at interview 69

Gender Female

Age at diagnosis 65

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For others, the onset of AF was associated with physical activities. Keith first had palpitations while playing cricket, while Janet found herself “getting very, very breathless” while walking uphill on holiday, and Ginny experienced a “pounding heart and a very, very fast pulse” while mountain climbing, which left her legs “a bit sort of weak.”

Suzy noticed her heart beating quite strongly’ after playing golf but did not realise her symptoms were AF.

Age at interview 49

Gender Female

Age at diagnosis 48

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Dave first sensed something was wrong while scuba diving when he found himself running out of oxygen.

Age at interview 61

Gender Male

Age at diagnosis 50

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When she saw her consultant for the first time, Maggie realised that she’d had symptoms of AF for some time, including palpitations when running up and down the stairs at work.

Age at interview 70

Gender Female

Age at diagnosis 61

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Some people saw their GP after becoming aware of a high heart rate while exercising. Paul wore a personal heart rate monitor at the gym, and thought it must be broken when he saw that his heart rate was high. When he borrowed another and his heart rate was still high, he saw his GP.

Raymond noticed a high heart rate while working out and feared he was going to have a heart attack.

David Y had his heart rate measured at the gym. When it remained high at rest, he visited his GP.

Age at interview 67

Gender Male

Age at diagnosis 64

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In some cases people may be unaware of symptoms of AF (described as ‘asymptomatic’), and are diagnosed by chance when they consult their doctor about other health concerns. (For more see Diagnosing atrial fibrillation and What having atrial fibrillation feels like).

Atrial fibrillation

Atrial fibrillation (AF) is a heart condition in which the heart beats irregularly and often abnormally fast. Symptoms can include palpitations, tiredness, and breathlessness. People...

Diagnosing atrial fibrillation

We asked people we interviewed to talk about their journey from symptoms to diagnosis. For some, getting a diagnosis of atrial fibrillation (AF) was straightforward...