Atrial Fibrillation - Heart Rhythm Evaluation

This often rapid, irregular heartbeat reduces the heart's ability to pump blood as effectively as it should.

This often rapid, irregular heartbeat reduces the heart's ability to pump blood as effectively as it should.

The heart is a hollow, muscular organ with four chambers.

  • The top two chambers are called the left and right atrium. The right atrium receives blood from the body. The left atrium receives blood from the lungs.
  • The bottom two chambers are called ventricles. The right ventricle receives blood from the right atrium and pumps it out to the lungs. The left ventricle receives blood from the left atrium and pumps it out to the rest of the body.
  • The heart's normal pacemaker initiates contractions of its four chambers in a regular, coordinated rhythm. A normal resting heart rate for is sixty to one hundred beats per minute. The beats happen at regular intervals.
  • An arrhythmia can cause the heart to beat irregularly (i.e., at varying intervals from beat to beat) and at abnormally fast or slow rates.

Atrial fibrillation (AF) is an irregular heartbeat. It interferes with the heart's ability to pump blood as effectively as it should. It is the most common long-term abnormal heart rhythm.

  • Normal atrial contractions squeeze blood out. However, atrial fibrillation causes the atria to “quiver” instead of contract.
  • The quivering can lead to pooling and clotting of the blood in the bottom of the atria. When the heart contracts it can push out one of one of the clots, or part of a clot. The clot can then travel to other organs and tissues in the body, including the brain, where it can cause tissue damage.
  • If untreated, atrial fibrillation can lead to a stroke. Therefore, patients with atrial fibrillation are often treated with a prescription blood thinner. The blood thinner stop clots from forming in the atria.

Some of the causes of atrial fibrillation include:

  • Enlarged heart
  • Various diseases of the heart muscle
  • Heart failure
  • Coronary artery disease
  • Heart valve disorders
  • High blood pressure
  • Pericarditis
  • Certain medications
  • Overactive thyroid gland
  • Excessive alcohol use
  • Obesity

Many people with AF do not have any of these risk factors. In addition, not everyone with AF has symptoms. If symptoms are present, they can include:

  • Palpitations
  • Feeling faint
  • Shortness of breath
  • Fatigue

If you have symptoms of atrial fibrillation, see your healthcare provider right away. He or she will check your medical history and examine you. A variety of tests may also be ordered to evaluate your heart.

  • An electrocardiogram (EKG) is usually the first test to detect an arrhythmia. It will only show arrhythmias that are present at the time of the recording.
  • If A-fib is suspected, but your symptoms come and go, a portable heart monitor may be recommended. You will wear the monitor for a few days to a few weeks. A portable heart monitor can pick up arrhythmias that come and go.
  • An electrophysiology study (EP study or cardiac mapping) may be done to find where the abnormal electrical impulses start.

AF is usually not immediately life threatening. However, it is serious and can cause a stroke if it is not adequately treated. There are many different treatments for atrial fibrillation. Three common treatments include medication, cardioversion, and surgery.

  • Different medications may be recommended to control your heart rate (how fast it beats) and rhythm. In addition, another medication will most likely be ordered to keep blood clots from forming in your atria.
  • Cardioversion is a procedure that uses an electric shock to convert an abnormal heart rhythm, such as AF, to a normal rhythm. (The amount of current used is much less than that given when your heart stops.). It can also be done by putting a specific medication into a vein.
  • Cardioversion is usually successful in returning a person to a normal heart rhythm. However, AF often recurs after a cardioversion.
  • Catheter ablation is a procedure where radiofrequency energy is used to destroy (ablate) abnormal electrical pathways in the heart. This energy is delivered through a catheter (tube) inserted through a large vein (usually through the groin). After the abnormal pathways are interrupted, the heart's electrical impulses are redirected down a normal pathway. This procedure is usually reserved for people whose AF is difficult to treat. It is generally not done on persons with newly diagnosed AF.
  • Surgery to make several specific incisions in the atria is an option if medication and other procedures do not control your atrial fibrillation. The incisions also help to stop abnormal pathways and redirect the electrical impulses down a normal pathway. This procedure is also reserved for people whose AF is difficult to treat. It is generally not done on people with newly diagnosed AF.

This care path includes the cost of a hospitalization, Electrophysiology Studies and coronary angiogram to evaluate the heart and its electrical system.

If you have any symptoms of atrial fibrillation, make an appointment with your healthcare provider right away. Ask your healthcare provider the following questions.

  • Do I need any special tests? What are the benefits and risks of having the tests?
  • Will the tests change your treatment recommendations? If not, is there a need for them?
  • What are my treatment options and what is the best treatment for me? What are the risks of each one?
  • Do I need to take a blood thinner? For how long? How often will I need blood work? Are there any specials precautions or dietary restrictions I should know?
  • What symptoms should I be concerned about?
  • Can my symptoms be controlled with medications? If so, are there Tier one or Tier two medications on my Prescription Drug List that I should take? How long will I need to take these medications? What are the side effects of my medications?

If you have a procedure to treat your AF, prior to discharge, you should understand all home care instructions. This includes:

  • Symptoms to report before your next appointment
  • Medications you need to take and their side effects
  • Follow-up plans

Some benefit plans recommend or require that members receive treatment for certain conditions (including cancer, bariatric surgery, bowel surgery, and heart procedures/surgeries) at a Center of Excellence (COE) facility.

  • If you have questions on COE benefits, call the number on your health plan ID card.
  • You can also go to and search under the extra programs section on the benefits and coverage tab.


Also known as:

Irregular Heartbeat
EP Studies
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