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Rapid Heartbeat (Palpitations, Tachycardia & AFib)

A racing, pounding or fluttering heartbeat is often harmless and linked to things like caffeine, stress or poor sleep, but it can also signal an arrhythmia such as supraventricular tachycardia or atrial fibrillation. Chest pain, fainting, severe shortness of breath or stroke signs with a fast heartbeat are emergencies: call 911. Tests, medicines, procedures and everyday habits can help.

Call 911 right away if a racing or irregular heartbeat comes with any of these: chest pain or pressure; shortness of breath; fainting or feeling like you are about to faint; or signs of a stroke — weakness or numbness on one side of the face or body, confusion or trouble speaking, blurred vision or loss of sight, or a severe headache (NHS (opens in a new tab), NHS (opens in a new tab), NHS (opens in a new tab)).

Also call 911 if a very fast heartbeat does not settle down and go away (NHS (opens in a new tab)), or if someone collapses and is not responding. A dangerous rhythm can lead to sudden cardiac arrest, which is fatal unless treated right away with CPR and a defibrillator; AEDs are made so that even untrained people can use them (NHLBI (opens in a new tab)). Use the BE FAST check for stroke: Balance, Eyes, Face, Arms, Speech, Time — call 9-1-1 right away if you see any of these signs (CDC (opens in a new tab)).

Do not drive yourself. Ask someone to drive you or call for an ambulance (NHS (opens in a new tab)). If you feel dizzy, faint or have palpitations, lie down; do not try to walk or drive (NHLBI (opens in a new tab)). Nothing on this page, including a vagal maneuver, a supplement or an appointment with a chiropractor, acupuncturist or massage therapist, is a reason to delay emergency care.

What is a rapid heartbeat?

Most adults have a resting heart rate between 60 and 100 beats per minute. It is normal for the rate to speed up with activity and slow down during rest or sleep, and it is normal to feel as if your heart skips a beat now and then (NHLBI (opens in a new tab), NHLBI (opens in a new tab)). Heart palpitations are when your heartbeat becomes more noticeable — it may feel like it is racing, irregular with skipped or extra beats, pounding or fluttering, and you may feel it in your chest, neck or throat. They can last seconds, minutes or longer, are common, and are usually not a sign of anything serious (NHS (opens in a new tab)).

An arrhythmia is a problem with the rate or rhythm of the heartbeat: too fast, too slow or irregular (NHLBI (opens in a new tab)). A resting rate faster than 100 is called tachycardia (NHLBI (opens in a new tab)). Some arrhythmias are harmless. But a frequent irregular rhythm can mean the heart is not pumping enough blood, and untreated arrhythmias can damage the heart, brain or other organs, leading to stroke, heart failure or cardiac arrest (NHLBI (opens in a new tab)). Arrhythmia may cause no symptoms at all (NHLBI (opens in a new tab)). This guide is written for adults; a fast heartbeat in a baby or child should be checked by their pediatrician.

To check your own pulse, gently place two fingers on the inner wrist below the thumb, count the beats for 30 seconds and double the number (NHLBI (opens in a new tab)).

Common types

  • Sinus tachycardia is a fast rate from the heart’s normal pacemaker. It is often explained by a medical condition that speeds the rate, such as anemia, infection, hyperthyroidism or a blood clot in the lungs, or by normal triggers. Experts say deciding when and how to intervene can be difficult, which is why it is worth having a fast resting rate checked (Mayuga et al., 2022 (opens in a new tab)).
  • Premature (extra) beats come too early, creating a pause and then a stronger beat that can feel like a skipped beat. NHLBI calls this a common type of arrhythmia (NHLBI (opens in a new tab)).
  • Supraventricular tachycardia (SVT). The heart suddenly beats much faster, above 100, and can then slow down abruptly. Episodes usually last a few minutes but sometimes hours, may be triggered by caffeine, alcohol or drugs (often there is no obvious trigger), and often start in children and young adults (NHS (opens in a new tab)). NHLBI says paroxysmal SVT begins and ends suddenly, is usually not dangerous and often happens in young people (NHLBI (opens in a new tab)).
  • Atrial fibrillation (AFib) and atrial flutter start in the upper chambers. AFib is the most common type of arrhythmia; the upper and lower chambers do not work together as they should (NHLBI (opens in a new tab), MedlinePlus (opens in a new tab)). Many people have no symptoms; the most common symptom is extreme tiredness (NHLBI (opens in a new tab)). It can raise the risk of stroke and heart failure (see below).
  • Ventricular tachycardia and ventricular fibrillation start in the lower chambers. NHLBI says ventricular arrhythmias can be very dangerous and usually require medical care right away; a few beats of ventricular tachycardia often cause no problem, but longer runs can lead to ventricular fibrillation, where cardiac arrest and death can happen within minutes (NHLBI (opens in a new tab)).

Common causes and triggers

Palpitations often come from everyday things: strenuous exercise, lack of sleep, stress and anxiety, medicines, and alcohol, caffeine, nicotine and recreational drugs. They can also come with menopause or pregnancy, or from a condition such as iron-deficiency anemia, an overactive thyroid, a heart rhythm problem or heart valve disease (NHS (opens in a new tab)). NHLBI lists these triggers:

  • blood sugar that is too low or too high; dehydration; low potassium, magnesium or calcium;
  • caffeine, illegal drugs and medicines that make you more alert or raise your energy;
  • strong emotional stress, anxiety, anger, pain or a sudden surprise; vomiting or coughing (NHLBI (opens in a new tab)).

NHLBI says certain antibiotics and over-the-counter allergy and cold medicines can raise the risk in some people, and that medicines for blood pressure or mental health conditions are worth discussing with your doctor. Other risk factors include age, family history, smoking, drinking more than the recommended amount of alcohol, and conditions such as heart disease, kidney or lung disease, obesity, sleep apnea, too much or too little thyroid hormone, and viral infections (NHLBI (opens in a new tab)). Never stop a prescribed medicine on your own; talk to your doctor first (NHLBI (opens in a new tab)). See our guides to thyroid problems, anemia, anxiety, blood pressure, sleep apnea and medication safety.

When to see a doctor (not an emergency): if palpitations keep coming back or happen more often, last longer than a few minutes, or you have a heart condition or a family history of heart problems (NHS (opens in a new tab)). If you have had palpitations that have now stopped but came with chest pain, shortness of breath or faintness, ask for an urgent appointment (NHS (opens in a new tab)). Also tell your provider if you keep getting a fast heartbeat, or if an SVT episode lasts longer than usual — in that case, call 911 (NHS (opens in a new tab)). Related guides: heart disease and fainting.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

Rapid Heartbeat (Palpitations, Tachycardia & AFib): six approaches compared
ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Find the rhythm with an ECG or a heart monitor and look for causes (thyroid, anemia, electrolytes, medicines). Treat the cause; use medicines (by class), vagal maneuvers, cardioversion, catheter ablation, pacemakers or ICDs; blood thinners to prevent stroke in AFib. Medicare Part B covers ECGs and other diagnostic tests: after the Part B deductible you pay 20% of the Medicare-approved amount. Ground ambulance is also 20% after the deductible. Other costs: being researched. Many palpitations need no treatment. SVT is often manageable and ablation is a treatment option; AFib is usually managed rather than cured, and stroke prevention is a key goal.
Chiropractic No established role in diagnosing or treating arrhythmia. We found little research: mainly a single case report. About $55 to $100 per follow-up visit paying cash, per The Pricer. Medicare covers only spinal adjustments for a subluxation. Never a substitute for 911 or a heart workup. Neck manipulation has been linked to rare tears in neck arteries that can cause a stroke. Tell the chiropractor about AFib or any blood thinner.
Acupuncture Studied as an add-on for arrhythmias, mostly AFib, in small trials of limited quality. About $90 to $185 per follow-up visit paying cash, per The Pricer. Medicare covers acupuncture only for chronic low back pain. Reviews report possible benefits but rate the evidence low to very low quality. No serious side effects were reported in them; blood thinners raised bleeding risk after acupuncture in one large study.
Herbal medicine Mostly a question of safety: caffeine-heavy products, bitter orange, yohimbe, ephedra and licorice have been linked to heart rhythm problems. One Chinese herbal extract has been studied for AFib. Cost estimate being researched. Evidence for any herb treating arrhythmia is of low quality. Some herbs interact with heart medicines. Tell your doctor and pharmacist about every product.
Massage therapy Relaxation massage for stress and tension. We found little research on massage for palpitations. One national chain: about $70 to $90 a month on a 12-month membership, per The Pricer. Medicare does not cover massage therapy. May help you feel calmer, but it does not treat an arrhythmia. Never press or massage the neck to try to slow your heart: carotid sinus massage is a clinician technique with rare but serious risks.
MBHA Wellness Coach Everyday habits that reduce triggers and support heart health: trigger and symptom diary, less alcohol, caffeine awareness, sleep, stress skills, activity, weight, taking medicines as prescribed. Cost estimate being researched. Trials show some habits, such as cutting alcohol, matter for AFib. Supports, and never replaces, medical care.

Approach 1 of 6

Conventional medicine (AMA)

Treatment depends on the cause and the type of rhythm. Palpitations often do not need to be treated (NHS (opens in a new tab)). If an arrhythmia is found, common treatments include medicines, devices that control the heartbeat and other procedures, plus healthy lifestyle changes (NHLBI (opens in a new tab)). The sections below cover Tests and diagnosis, What to do during an episode, Procedures and devices and Atrial fibrillation and stroke prevention.

Medicines (by class; we do not list doses)

  • For a fast heartbeat: NHLBI lists adenosine (given by EMS or in the ER), beta blockers, calcium channel blockers, digoxin (used for AFib) and potassium channel and sodium channel blockers, each with its own side effects. Too high a dose of an arrhythmia medicine can make an arrhythmia worse, which happens more often in women than in men; tell your doctor if symptoms get worse (NHLBI (opens in a new tab)).
  • Rate control and rhythm control in AFib: rate control slows the lower chambers so you may feel better even though the rhythm stays abnormal; rhythm control medicines try to restore a steady rhythm, and are recommended for people who still have symptoms, who recently developed AFib, or who are highly active (NHLBI (opens in a new tab)).
  • Blood thinners (anticoagulants) prevent clots and lower the risk of stroke; they carry a risk of bleeding (NHLBI (opens in a new tab), MedlinePlus (opens in a new tab)). See below.
  • Treating the cause: your doctor may treat low electrolytes, high blood pressure, heart disease, sleep apnea or thyroid disease; sometimes the problem is a medicine, and treating the condition or stopping the medicine can improve symptoms (NHLBI (opens in a new tab), NHS (opens in a new tab)).

What it costs

Medicare Part B covers diagnostic tests such as ECGs when your provider orders them to find or treat a problem; after the deductible you pay 20% of the Medicare-approved amount, with a hospital outpatient copayment if done at a hospital (Medicare.gov (opens in a new tab)). Medicare Part B also covers ground ambulance when any other transport could endanger your health, with the same 20% after the deductible (Medicare.gov (opens in a new tab)). Other costs: being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no role in emergency care or in diagnosing or treating an arrhythmia. A fast or irregular heartbeat needs a medical evaluation first.

What the research shows

We found little research. A single published case report describes a 60-year-old man whose arrhythmia, which appeared when he turned his head, improved after upper-neck adjustments; the authors themselves describe a “paucity” of published reports on treating arrhythmias with manipulation, and one case cannot show that adjustments work (Shreeve & La Rose, 2011 (opens in a new tab)).

Safety

NCCIH says serious side effects from spinal manipulation are very rare but have been reported, and may be more likely in people with underlying health problems. A type of manipulation that focuses on the neck has been linked to small, potentially dangerous tears in neck artery walls that are rare but can lead to a stroke (NCCIH (opens in a new tab)). Since AFib can itself raise stroke risk (CDC (opens in a new tab)), MBHA suggests telling your chiropractor about any arrhythmia or blood thinner, and asking your doctor whether neck thrust techniques are right for you; gentler methods may be an option. New severe neck pain or headache, especially with any stroke sign, is a reason to call 911 — not to book an adjustment. See our stroke guide.

What it costs

The Pricer lists about $55 to $100 for a self-pay follow-up visit and $90 to $200 for a first appointment (The Pricer (opens in a new tab)). Medicare covers only spinal adjustments by a chiropractor to correct a subluxation (Medicare.gov (opens in a new tab)).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Some people try acupuncture alongside usual care for arrhythmias. The research is limited and low in quality; none of it suggests acupuncture should replace evaluation or treatment.

  • A 2024 review of 15 randomized trials (1,960 people) with AFib found that acupuncture raised the rate of return to normal rhythm and, added to usual treatment, lowered the ventricular rate; no severe adverse reactions were reported. The authors said the small number of studies may limit how far the findings apply (Liu et al., 2024 (opens in a new tab)).
  • A 2018 review of nine trials (638 people) with several arrhythmias found only one trial at definitely low risk of bias. Acupuncture alone did not do significantly better than amiodarone in AFib and atrial flutter, and the authors could not reach a robust conclusion because of low-quality evidence (Liu et al., 2018 (opens in a new tab)).
  • A 2025 overview of 10 reviews of acupuncture for arrhythmias rated the methods of the reviews as very low quality and the evidence mostly low or very low, and called for better research (Ci et al., 2025 (opens in a new tab)).

So acupuncture may be a calming add-on, but we cannot say it treats arrhythmia.

Safety

NCCIH says relatively few complications have been reported, mostly from nonsterile needles or improper treatment (NCCIH (opens in a new tab)). In a Taiwanese study covering more than 13 million acupuncture sessions, anticoagulants raised the risk of minor bleeding (skin bleeding or bruising) after acupuncture; the increase in major bleeding did not reach statistical significance (Hsieh et al., 2023 (opens in a new tab)). If you take a blood thinner for AFib, tell your acupuncturist.

What it costs

The Pricer lists about $90 to $185 per follow-up visit and up to about $230 for a first private appointment, with community acupuncture around $50 to $90 (The Pricer (opens in a new tab)). Medicare covers acupuncture only for chronic low back pain (Medicare.gov (opens in a new tab)).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement is proven to treat an arrhythmia. For a rapid heartbeat, the main issue is safety: some products can cause or worsen heart rhythm problems, and some interact with heart medicines. “Natural” does not always mean safe (NCCIH (opens in a new tab)). NHLBI advises checking with your doctor before taking over-the-counter medicines, nutritional supplements, or cold and allergy medicines (NHLBI (opens in a new tab)).

Products linked to heart rhythm problems

  • Caffeine and energy drinks. NCCIH says large amounts of caffeine may cause serious heart and blood vessel problems, including heart rhythm disturbances and increases in heart rate and blood pressure (NCCIH (opens in a new tab)). See also the research on coffee in the wellness coach section.
  • Bitter orange supplements: cases of abnormal heart rhythms, heart attacks and strokes have been reported in people taking bitter orange products, but most contained several ingredients, so it is unclear whether bitter orange caused them. an FDA analysis of 59 products found many did not contain the amount stated on the label (NCCIH (opens in a new tab)).
  • Ephedra: the FDA has banned supplements containing ephedrine alkaloids because of serious safety risks, including high blood pressure, heart attack and stroke (NCCIH (opens in a new tab)).
  • Yohimbe: yohimbine has been associated with cardiac arrhythmia, blood pressure problems and heart attacks; a poison-center analysis found yohimbe caused problems including rapid heartbeat, and products are inconsistently labeled (NCCIH (opens in a new tab)).
  • Licorice root: glycyrrhizin in licorice can cause irregular heartbeat and cardiac arrest, especially in large amounts or long-term use, and even small amounts have been linked to severe effects in people with high blood pressure, heart or kidney conditions or a high-salt diet (NCCIH (opens in a new tab)).
  • St. John’s wort can weaken some heart medicines, including digoxin and ivabradine (NCCIH (opens in a new tab)).

A Chinese herbal extract studied for AFib

Wenxin Keli is a Chinese herbal extract widely used in China for AFib. A 2022 overview of eight reviews found the reviews were of very low methodological quality and the evidence mostly low or very low; the authors said it may be clinically effective and safe but that the findings should be viewed with caution (Wang et al., 2022 (opens in a new tab)). We cannot recommend it, and we have not found information on how consistent products are; ask your cardiologist.

Never skip or stop a heart or blood thinner medicine to take a supplement, and show every product to your doctor or pharmacist. Do not try an herb during an emergency — call 911. We don’t list doses.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage can help you relax, which may ease stress that triggers palpitations. But we found little research on massage as a treatment for palpitations or arrhythmia; a PubMed search on massage and arrhythmia mostly turned up studies of carotid sinus massage, a different thing.

Do not massage or press on your own neck to try to slow your heart. Carotid sinus massage is a vagal maneuver done by clinicians. One review found it exposes the patient to rare but potentially devastating harm, that its effectiveness in stopping SVT appears modest at best, and that safer, easier options such as the Valsalva maneuver exist (Collins & Higgins, 2015 (opens in a new tab)). A 2024 analysis of three trials (346 people) found the Valsalva maneuver worked better than carotid sinus massage in SVT, though the authors noted concerns about bias in all three (Alfehaid et al., 2024 (opens in a new tab)).

Safety

  • NCCIH says the risk of harm from massage appears low, though there are rare reports of serious effects such as a blood clot, nerve injury or bone fracture, some after vigorous deep-tissue massage (NCCIH (opens in a new tab)).
  • Bleeding is the most common side effect of blood thinners, and unusual bruising is one warning sign; MBHA suggests asking for lighter pressure and telling the therapist if you take one (MedlinePlus (opens in a new tab)).
  • If you feel your heart racing, chest pain or faintness during a session, stop and get medical care.

What it costs

One national chain’s membership runs about $70 to $90 a month on a 12-month term (The Pricer (opens in a new tab)). Medicare does not cover massage therapy (Medicare.gov (opens in a new tab)).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you spot patterns, reduce triggers and build habits that support your heart — alongside, never instead of, a medical evaluation and your medicines.

Track what you feel

NHLBI suggests keeping track of when and how often you have symptoms, what you feel, what you were doing, and whether this changes over time (NHLBI (opens in a new tab)); learning to take your pulse and keeping a record to share with your doctor (NHLBI (opens in a new tab)). A coach can help you keep a simple diary of episodes, sleep, caffeine, alcohol and stress to bring to your appointment.

Alcohol

NHLBI says to limit or avoid alcohol and stimulants if you have AFib (NHLBI (opens in a new tab)). In an open-label Australian trial of 140 adults with AFib who drank 10 or more standard drinks a week, those assigned to abstain had a recurrence of AFib in 53% over 6 months, versus 73% of those who continued drinking, and spent less time in AFib (Voskoboinik et al., 2020 (opens in a new tab)).

Caffeine: what trials show

Caffeine is a listed trigger for palpitations (NHLBI (opens in a new tab), NHS (opens in a new tab)), and NHLBI says to avoid or limit it if it is your trigger (NHLBI (opens in a new tab)). But a 2026 open-label JAMA trial of 200 coffee drinkers with persistent AFib or flutter who were having a cardioversion found less recurrence in those assigned to drink about a cup of caffeinated coffee a day (47%) than in those told to abstain (64%) (Wong et al., 2026 (opens in a new tab)). This does not mean caffeine is harmless for everyone, especially in energy drinks or large amounts; notice what your own body does, and talk with your doctor.

Weight, activity and mind-body habits

  • Weight: NHLBI says a healthy weight can reduce the severity and number of AFib episodes (NHLBI (opens in a new tab)). In an observational follow-up of 355 people with AFib who were overweight or obese, those who lost 10% or more of their body weight had a greater drop in AFib burden and symptoms than those who lost less (Pathak et al., 2015 (opens in a new tab)).
  • Activity: a review of 13 randomized trials (1,155 people) found supervised exercise training reduced AFib recurrence and improved quality of life, with no difference in adverse events (Oesterle et al., 2022 (opens in a new tab)). NHS advises not to exercise too hard, because that can trigger AFib (NHS (opens in a new tab)), so ask your doctor what is safe (NHLBI (opens in a new tab)).
  • Yoga: in a pilot study of 80 people with paroxysmal AFib, 12 weeks of yoga added to usual treatment was associated with lower heart rate and blood pressure and a higher mental-health score, though the groups differed in quality of life at the start (Wahlström et al., 2017 (opens in a new tab)).

Stress and sleep

NHLBI suggests stress-reducing activities such as talking to a counselor, a stress management program, meditation, being active and relaxation techniques; ask your provider what is safe for you (NHLBI (opens in a new tab)). NHLBI says sleep helps repair the heart and blood vessels and that too little quality sleep raises heart risks (NHLBI (opens in a new tab)); NHS lists lack of sleep as a trigger (NHS (opens in a new tab)). Living with an arrhythmia may cause fear, anxiety and depression; support from a counselor, a patient group, family and friends can help (NHLBI (opens in a new tab)). See our anxiety guide.

What it costs

Cost estimate being researched.

Another approach

Tests and diagnosis

Your doctor will ask about your symptoms, lifestyle and family history, check your pulse, listen to your heart and look for signs of other conditions, such as thyroid disease (NHLBI (opens in a new tab)).

What it costs

See the conventional medicine tab: Medicare Part B covers ECGs and other diagnostic tests with 20% coinsurance after the deductible (Medicare.gov (opens in a new tab)). Other costs: being researched.

Another approach

What to do during an episode

First, check for danger. If you have chest pain, trouble breathing, faintness, stroke signs or the rapid heartbeat does not settle, call 911 (see the red box at the top). Lie down if you feel dizzy or faint, and do not walk or drive (NHLBI (opens in a new tab)).

Vagal maneuvers

Vagal maneuvers are relaxation techniques that may help slow the heart rate. NHLBI lists coughing or gagging, holding your breath and bearing down (the Valsalva maneuver), lying down, and placing a towel dipped in ice-cold water over the face, and says your healthcare team may guide you through them (NHLBI (opens in a new tab)). NHS says that for SVT a doctor may recommend simple techniques to help stop episodes (NHS (opens in a new tab)). NHLBI advises asking your doctor which techniques are right for you to do at home (NHLBI (opens in a new tab)). MBHA suggests learning them from your clinician rather than trying them on your own for the first time during an episode.

  • In a randomized trial in English emergency departments, 433 adults enrolled with SVT (not AFib or flutter) tried either a standard or a modified Valsalva maneuver in which the person lies back with legs raised right after the strain. Normal rhythm at one minute was reached in 43% with the modified version versus 17% with the standard version, with no serious adverse events recorded (Appelboam et al., 2015 (opens in a new tab)).
  • A Cochrane review of the standard Valsalva maneuver found three trials and not enough evidence to support or refute its effectiveness for stopping SVT (Smith et al., 2015 (opens in a new tab)).
  • Do not use carotid sinus massage on yourself (see the massage tab).

If an episode of SVT lasts longer than usual, or comes with shortness of breath, chest pain or faintness, go to the hospital immediately (NHS (opens in a new tab)).

Another approach

Procedures and devices

If medicines do not control the arrhythmia, you may need a procedure or device (NHLBI (opens in a new tab)).

  • Cardioversion uses external electric shocks to restore a normal rhythm. It is done under anesthesia and takes a few minutes; you will not feel pain from the shocks. It is uncommon, but it can cause or worsen dangerous arrhythmias or cause clots to travel and cause a stroke; taking anticlotting medicines before and after reduces this risk. In an emergency, when it is used for dangerous rhythms in the lower chambers, it is called defibrillation (NHLBI (opens in a new tab)).
  • Catheter ablation passes thin tubes through blood vessels to the heart and uses heat, extreme cold or laser light to create a small scar that blocks abnormal signals. Risks include bleeding, infection, blood vessel or heart damage, arrhythmias and blood clots (NHLBI (opens in a new tab)). In AFib, it is not always successful and AFib is most likely to come back in the first few weeks, when it may be repeated (NHLBI (opens in a new tab)). For SVT, NHS says ablation permanently cures the problem in most people (NHS (opens in a new tab)).
  • Pacemakers send electrical pulses to help the heart beat at a normal rate and rhythm (NHLBI (opens in a new tab)). For AFib, a pacemaker is typically used only when AFib occurs together with another arrhythmia such as a slow heart rate (NHLBI (opens in a new tab)).
  • Implantable cardioverter defibrillators (ICDs) are surgically placed devices that detect a life-threatening rhythm and send a shock; they can prevent sudden death in people at high risk, and some also act as pacemakers (NHLBI (opens in a new tab), MedlinePlus (opens in a new tab)). Getting a pacemaker or ICD takes minor surgery, usually a day or two in the hospital, and a return to normal activities within a few days (MedlinePlus (opens in a new tab)). See our guide to living with pacemakers and defibrillators.
  • Surgery such as the Maze procedure is usually considered for AFib only if you are having surgery for another heart problem (NHLBI (opens in a new tab)).

What it costs

Cost estimate being researched.

Another approach

Atrial fibrillation and stroke prevention

With AFib, blood can pool in the heart and form clots, which can travel to the brain and cause a stroke (NHLBI (opens in a new tab)). CDC says AFib causes about 1 in 7 strokes, and strokes related to AFib tend to be more severe (CDC (opens in a new tab)). Many people with AFib have no symptoms and do not know they have it (MedlinePlus (opens in a new tab)), so a check for AFib (for instance with an ECG) is worth asking for if you have palpitations or risk factors such as being 65 or older (NHLBI (opens in a new tab)). If you have had a stroke with no clear cause, NHLBI says your provider may look for AFib with a monitor (NHLBI (opens in a new tab)).

  • Blood thinners such as warfarin and the direct-acting oral anticoagulants are used to prevent clots and lower stroke risk if you are at risk of a stroke; they carry a risk of bleeding (NHLBI (opens in a new tab)). They do not break up existing clots (MedlinePlus (opens in a new tab)). Take them exactly as prescribed, tell every provider you take one before any surgery or test, and ask a pharmacist before taking other medicines (NHS (opens in a new tab)). Call your provider about signs of serious bleeding, such as black or red bowel movements, red or brown urine, a nosebleed or cut that will not stop, or a severe headache (MedlinePlus (opens in a new tab)).
  • If you cannot take blood thinners, closing off the left atrial appendage can reduce clot risk; it can be hard to close fully, and leaks continue to raise clot risk (NHLBI (opens in a new tab), MedlinePlus (opens in a new tab)).
  • NHS says there is currently no cure for AFib, but treatment helps manage symptoms and lower the risk of complications (NHS (opens in a new tab)).

Learn the stroke signs in our stroke guide, and see our guide to blood clots.

Another approach

Living with an arrhythmia

NHLBI recommends following your treatment plan and keeping your appointments, and bringing a list of all your medicines to every visit (NHLBI (opens in a new tab)). Other practical steps it lists:

  • have a plan for what to do if your rhythm acts up, and tell people you might faint;
  • carry a medical ID with your condition and your doctor’s contact information;
  • consider asking a loved one to learn CPR, and ask about keeping an AED at home or work if your doctor thinks you are at risk;
  • tell your doctor if your symptoms get worse or new ones appear — arrhythmias can become more common and last longer over time (NHLBI (opens in a new tab)).

See also our heart disease guide and blood pressure guide.

Member stories

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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