How is atrial fibrillation diagnosed?

Atrial fibrillation can be chronic and sustained, or brief and intermittent (paroxysmal). Paroxysmal AF refers to intermittent episodes of atrial fibrillation lasting, for example, minutes to hours. The heart rate reverts to normal between episodes. In chronic, sustained AF, the atria fibrillate all of the time. Chronic, sustained AF is not difficult to diagnose. Doctors can hear the rapid and irregular heartbeats using a stethoscope. Abnormal heartbeats also can be felt by taking a patient's pulse.

 
The evaluation of patients who develop atrial fibrillation includes a medical history and physical examination, an electrocardiogram (ECG), and an echocardiogram (cardiac echo). The doctor usually asks if there is a history of heart problems (such as heart attack) or chest pains (which might suggest coronary artery disease); if they suddenly develop a sensation of shortness of breath and chest pains (which can suggest that a blood clot has broken off from a blood vessel in the legs and traveled to the lungs); if they are losing weight or feel hot all the time (symptoms of an overactive thyroid gland); or if they regularly consume alcohol.