Your doctor will perform a physical examination, ask about your symptoms and discuss your medical history. He will suggest one or more diagnostic tests. These include:
- Electrocardiogram (ECG). An electrocardiogram records electrical signals as they travel through your heart. It is the primary tool for diagnosing atrial fibrillation.
- Holter monitoring is a type of ECG. You wear a portable monitor for 24 hours as you go about your normal activities. It provides your doctor with a prolonged look at your heart rhythms.
- Event recorder is a portable ECG device that monitors your heart activity over a few weeks to a few months. You activate it only when you experience symptoms of a fast heart rate.
- Echocardiogram uses sound waves to produce images of your heart. It provides information about the size and shape of your heart and how well your heart chambers and valves are working. The test also can identify areas of poor blood flow to the heart, areas of heart muscle that aren’t contracting normally, and previous injury to the heart muscle caused by poor blood flow.
- Stress test. Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done.
- Blood test to check for hyperthyroidism or other substances in your blood that may lead to atrial fibrillation.
- Chest x ray allows your doctor to diagnose conditions other than atrial fibrillation that may explain your signs and symptoms.
If you have atrial fibrillation, you will likely take a medicine to help prevent a stroke. You may also take a medicine that slows your heart rate or controls your heart rhythm.
Anticoagulant medicines, also called blood thinners, are recommended for most people with atrial fibrillation who are at average to high risk of stroke. These include warfarin, apixaban, and dabigatran.
If you are at low risk of having a stroke or cannot take anticoagulants, you may choose to take daily aspirin or to not take a blood thinning medicine.
Rate-control medicines are used if your heart rate is too fast. The medicine slows your heart rate. These medicines include beta-blockers, calcium channel blockers, and digoxin.
Rhythm-control medicines (also known as antiarrhythmics) help return the heart to its normal rhythm and keep atrial fibrillation from returning. They may help relieve symptoms caused by an irregular heart rate.
Electrical cardioversion uses a low-voltage electrical shock to return an irregular heartbeat to a normal rhythm.
Catheter ablation is a minimally invasive procedure. It destroys the heart tissue that causes atrial fibrillation and that keeps atrial fibrillation going after it starts.