Atrial fibrillation and heart failure

A fast or irregular rhythm may reduce how efficiently the heart fills and pumps. Pressure and stretching within a failing heart can also make atrial fibrillation more likely to persist.

Either condition may cause breathlessness, reduced exercise tolerance, tiredness, dizziness, or palpitations. Heart failure commonly presents with breathlessness and fluid-related ankle swelling; symptoms can change when atrial fibrillation makes the heartbeat too rapid or irregular.

Assessment may include the pulse, blood pressure, an electrocardiogram, blood tests, and an ultrasound scan of the heart. Clinicians also look for triggers or contributors such as infection, thyroid disturbance, anaemia, kidney problems, uncontrolled blood pressure, or missed medicines.

Take heart medicines exactly as prescribed and keep an up-to-date list. Treatment may slow the heart rate, support pumping, relieve excess fluid, or restore rhythm in selected people. Anticoagulants may be prescribed to reduce clot-related stroke risk; they do not treat breathlessness directly.

Monitor the features named in your care plan, which may include pulse, blood pressure, weight trends, swelling, breathing, and ability to complete usual activities. Contact the care team if symptoms gradually worsen or side effects make it difficult to continue treatment.

Call emergency services for severe breathlessness at rest, chest pressure, collapse, new confusion, blue or grey lips, or signs of stroke such as facial droop, arm weakness, or speech difficulty. Sudden symptoms should not wait for a routine appointment.

Seek prompt advice for rapidly increasing ankle or abdominal swelling, needing more pillows to breathe, waking gasping, a sustained racing heartbeat, marked dizziness, or a clear decline in daily function. These changes can indicate fluid build-up or poor heart-rate control.

Ask for your target pulse and blood pressure ranges, which changes should trigger contact, and how kidney function and electrolytes will be monitored. Confirm what to do after a missed anticoagulant or diuretic dose rather than doubling medication without advice.