Living With the Long-Term Effects of AFib and Its Progression

AFib is the most common long-lasting heart rhythm problem in the world.¹ In the United States, about 10.5 million Americans are living with AFib. As the population ages, this number is expected to grow.¹

AFib happens when the heart’s electrical signals don’t work the right way. This causes the atria (upper chambers of the heart) to beat out of rhythm. The heart may also beat too fast. When this happens, the heart can’t pump blood as well as it should. Over time, this puts extra strain on the heart. AFib is associated with higher rates of stroke, heart failure, hospitalization, and death compared to people without the condition.²

AFib is a progressive disease, so if left untreated, it often gets worse over time.  It can worsen faster when contributing risk factors such as high blood pressure, diabetes, obesity, or sleep apnea aren’t well controlled.²

Here’s how AFib can change over time:

• AFib often begins as “paroxysmal AFib.” This means episodes come and go, usually lasting less than seven days.³ Symptoms may include palpitations, fatigue, shortness of breath, or dizziness. However, some people experience few or no noticeable symptoms. Even at this stage, repeated AFib episodes can alter the heart’s electrical pathways and structure. This raises the likelihood that AFib will return.³
• Over time, paroxysmal AFib may progress to “persistent AFib.” In persistent AFib, episodes last longer than a week and may require medical intervention to restore normal heart rhythm.³
• Some individuals eventually develop long-standing persistent or “permanent AFib.” The more time the heart spends in AFib, the higher the risk of blood clots, stroke, heart failure, or other long-term effects.³

Stroke is one of the most serious risks of AFib.² When the heart beats out of rhythm, blood can pool inside the heart. Over 90% of stroke-causing clots form in a small pouch called the left atrial appendage.⁴ Stagnant blood is more likely to form clots. If a clot travels from the heart to the brain, it can block blood flow, leading to an ischemic stroke.²

People with AFib are approximately five times more likely to have a stroke than those without it.⁵ AFib is also associated with heart failure, reduced quality of life, cognitive decline, and increased mortality. 

Stroke risk in AFib isn’t static. It increases with age and as AFib gets worse. Blood thinners can lower the risk, but they must be taken regularly and can increase the risk of bleeding. Because AFib is a lifelong condition, doctors need to check stroke and bleeding risk often and adjust treatment as health needs change.⁶

Learn more about the connection between AFib and stroke risk.

Maintaining your current treatment plan might mean taking rate and rhythm medications or blood thinners long-term, as long as symptoms seem stable or stroke risk appears controlled. This approach works well for some. However,  AFib can get worse without causing clear symptoms. An irregular heartbeat can still strain the heart and raise the risk of problems over time.

It’s important to talk to your doctor regularly about your treatment plan and how it works for your lifestyle. Active AFib management can look like regular follow-ups, reassessment of symptoms and stroke risk, and proactive conversations with a doctor about how treatment strategies should change as AFib changes and evolves.

There's no one heart rate that’s dangerous for everyone. But when the heart beats too fast for long periods, it can weaken the heart. Over time, this increases the risk of heart failure.²

It’s important to recognize that AFib can appear “silent.” It can still raise the risk of stroke and heart failure, even without obvious symptoms.² Routine monitoring and proactive care are critical, regardless of how stable symptoms may appear to be. 

AFib is rarely life-threatening on its own. However, it significantly increases the risk of serious complications. People with AFib have a higher risk of stroke, heart failure, and hospitalization compared to those without the condition.² Without active long-term management, these complications can become life-threatening over time.

Learn more about the long-term risks of AFib.

Treating AFib with cardiac ablation has been shown to slow its progression.⁷ It’s possible to get an ablation and a WATCHMAN Implant at once, treating AFib symptoms and stroke risk in one combined treatment. 

Learn more about getting both procedures at the same time.

AFib is associated with an increased risk of death. This is largely due to complications such as stroke and heart failure. Studies show that people with AFib have a higher mortality risk than those without it.⁵ Follow-up care and active disease management can significantly mitigate these risks.

Many people with AFib are able to live active and fulfilling lives, especially with appropriate treatment and ongoing management. Medications, lifestyle changes, and medical procedures can help control symptoms and reduce complications. Outcomes are generally better for people who actively manage AFib and address related health conditions.

Living with AFib isn’t just about managing current symptoms — it’s about preserving long-term health for years to come. Recognizing AFib as a progressive condition can help you be more proactive in conversations with your doctor.