Lowering your AFib risk
Atrial fibrillation is not just bad luck. Most of what drives it is in your daily life, and changing those things can prevent it or make it go away.
From Dr. Kenny Civello, cardiologist and electrophysiologist
Medicines and ablation treat the rhythm. They do not fix what caused it. Extra weight, alcohol, high blood pressure, poor sleep, and too little exercise slowly change the upper chambers of the heart. Treating those causes makes every other AFib treatment work better and last longer.
It is common
Between 1 in 3 and 1 in 5 adults will get AFib at some point in their life.
It raises stroke risk
AFib makes a stroke about five times more likely. Your stroke risk is checked separately and may call for a blood thinner.
It can reverse
In people who lose weight and treat their risk factors, AFib often becomes less frequent. Some stop having it.
Quick check
Check each one that applies to you. Nothing you enter leaves this device.
What you can change
These have the strongest evidence. The 2023 national AFib guideline recommends all of them.
Weight
- For a 220 pound person, that is 22 pounds.
- Keep it off. Weight that swings up and down helps less.
- Medicines like Wegovy or Zepbound can help. Ask us.
Why
Extra fat around the heart stretches and inflames the upper chambers. In studies, people who lost 10% or more of their weight were far more likely to be free of AFib years later than people who lost little or none.
Alcohol
- Even one drink a day raises AFib risk.
- Binge drinking is a common trigger for an episode.
- Stopping completely works best if you already have AFib.
Why
In a trial of regular drinkers with AFib, the people who stopped drinking had fewer AFib episodes and went longer before AFib came back than the people who kept drinking.
Exercise
- That is 30 minutes a day of brisk walking, cycling, or swimming.
- Start where you are and build up over a few months.
- Fitness itself protects you. Every step up in fitness lowers risk.
Why
Fit people have less AFib, and people with AFib who improve their fitness have fewer episodes. The goal of about 210 minutes a week of moderate to vigorous exercise comes straight from the guideline.
Blood pressure
- Check it at home with an upper arm cuff.
- Less salt, more exercise, and weight loss all lower it.
- Take blood pressure medicine every day if it is prescribed.
Why
High blood pressure is the most common treatable cause of AFib. Years of high pressure stiffen the heart and enlarge the upper chambers.
Sleep apnea
- Loud snoring, gasping, and daytime sleepiness are warning signs.
- A home sleep test is simple.
- Use CPAP or another treatment every night if you need it.
Why
Each pause in breathing drops oxygen and spikes blood pressure. Sleep apnea is very common in people with AFib. Treating it helps your heart and makes AFib easier to control. See the sleep guide.
Smoking
- This includes vaping and chewing tobacco.
- Nicotine patches, gum, and prescription medicines double your chance of quitting.
- Free help: call 1 800 QUIT NOW.
Why
Smoking damages blood vessels and heart tissue and raises the risk of AFib and stroke. Quitting lowers both.
Blood sugar
Diabetes raises AFib risk. Keeping your A1c in range helps. Some newer diabetes medicines also protect the heart. Ask us if one is right for you.
Thyroid
An overactive thyroid can trigger AFib. A simple blood test checks it. Treating it often stops the AFib.
What you cannot change
These raise your risk too. They are a reason to work harder on the list above, not a reason to give up.
Age
The biggest single risk factor. AFib becomes much more common after 65.
Family history
AFib in a parent or sibling raises your risk, especially if they got it young.
Sex and height
Men get AFib at younger ages. Taller people also have a higher risk.
Heart conditions
Heart failure, valve disease, coronary disease, and past heart surgery all raise risk.
Common questions
Does coffee cause AFib?
No. Regular coffee drinkers have the same or lower rates of AFib. In a recent trial of people with AFib, those who kept drinking coffee had less AFib come back than those who quit. Energy drinks are different. Avoid them.
I exercise a lot. Can that cause AFib?
Years of very high volume endurance training, like marathons or long distance cycling, can raise AFib risk, mostly in men. This is far less common than AFib from too little exercise. If you are an endurance athlete with palpitations, talk with us. Do not stop exercising on your own.
My watch says I might have AFib. What now?
Do not ignore it, and do not panic. Save the ECG recording if your watch makes one and bring it to your visit. Watch alerts are good at catching AFib but are not a diagnosis. We confirm it with a medical ECG or a monitor. See the watch alert guide.
If I fix my risk factors, can I stop my blood thinner?
Not on your own. Your need for a blood thinner depends on your stroke risk score, not on how often you feel AFib. Never stop a blood thinner without talking with us.
Will an ablation fix the problem so I do not need to change anything?
Ablation works better and lasts longer in people who also treat their risk factors. Weight, alcohol, blood pressure, and sleep apnea keep acting on the heart after an ablation.
Where to start
Do not try to change everything this week. Pick one.
If you drink most days
Start with alcohol. It is the fastest change to make and you will see results within weeks.
If you snore
Ask us for a sleep test. It takes one night at home.
If you carry extra weight
Set a goal of 10%. The eating guide shows what to change first.
If none of these apply
Buy a home blood pressure cuff and start walking 30 minutes a day.
When to call us
- A racing or irregular heartbeat that is new or happening more often
- Your watch or monitor shows AFib you did not know about
- Shortness of breath or swelling in your legs
- Bleeding while on a blood thinner
Call 911 for chest pain, fainting, or signs of stroke: face drooping, arm weakness, or trouble speaking.
Other guides
Lowering your blood pressureEating for your heartSleeping wellLiving with POTSMy watch says I have AFibGetting ready for your ablationLiving with a pacemaker or ICDThis page is general education for my patients. It does not replace advice from your own doctor. Talk with us before starting a new medicine or exercise program.
Based on: Joglar JA, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation. Circulation. 2024.