Atrial fibrillation (AFib) is a heart condition, so heart specialists, known as cardiologists, diagnose and treat it. However, cardiology has different specialties and other health professionals also play a role.
For some people, the first doctor they see for AFib is a primary care physician or family doctor. Others who experience severe or alarming symptoms may go to the emergency room (ER), where an emergency doctor will assess them.
If the person’s symptoms need further investigation, one of these doctors will refer them to a cardiologist.
Keep reading to learn which doctors diagnose and treat AFib.
Medical professionals who can help diagnose AFib include:
- primary care physicians
- ER or urgent care doctors
- cardiologists, who specialize in cardiovascular conditions
- electrophysiologists, who are cardiologists who specialize in heart rhythm and electrical activity
- in some cases, emergency medical personnel (EMTs), physician assistants, or nurses
People may begin the process of getting a diagnosis by seeing their primary care doctor. This could be for a routine checkup or to discuss symptoms. The doctor may then refer to a cardiologist if there is evidence they could have a heart condition.
There are also more specialized pediatric cardiologists who have expertise in heart conditions in children.
Many of the same doctors who help diagnose AFib can also help with treating it. Depending on the situation, a person may receive treatment from a:
- primary care physician
- ER doctor
- cardiologist
- electrophysiologist
- cardiovascular surgeon, who can carry out surgery on the heart and blood vessels
To diagnose AFib,
- ask about any symptoms, such as palpitations or dizziness
- discuss the person’s medical history
- assess any risk factors that may have for AFib, such as smoking or substance use
- ask about any family history of cardiovascular disease
- carry out a physical examination, including:
- checking for an enlarged thyroid gland or goiter
- looking for swelling in the limbs
- taking a pulse to see how quickly the heart is beating
- listening to the chest to check for anything unusual in the heart rhythm or lungs
- measuring blood pressure, height, and weight
If the doctor notices anything unusual, they may recommend diagnostic tests.
Diagnostic tests
Some tests that can help diagnose AFib
- Electrocardiogram (EKG): EKGs record the person’s heart activity by measuring its electrical impulses.
- Echocardiography: An echocardiogram is an ultrasound scan that shows the valves and chambers of the heart, how well it is pumping, and if there are any clots.
- Cardiac MRI and other imaging tests: These can check how well the heart is working and help calculate the level of risk of AFib-related complications, such as a stroke or heart failure.
- Blood tests: Blood tests can measure substances such as potassium and thyroid hormone, which could indicate AFib. A complete blood count may detect an underlying infection.
- Liver and kidney function tests: These blood tests can show if there are problems with the liver or kidney, which may have implications for both diagnosis and treatment.
- Chest X-rays: An X-ray can detect signs of complications, such as fluid buildup or an enlarged heart.
- Electrophysiology study: These can identify different types of arrhythmia by recording the heart’s electrical signals.
- Holter monitors and loop recorders: For these tests, a person wears a device that records information about their heart activity. It may send the data directly to the cardiology department.
- A stress test or walking test: In a stress test, a person exercises under supervision while healthcare professionals gather data. A walking test is similar.
- A sleep study: This can detect if a sleep disorder, such as sleep apnea, could be causing the symptoms.
- Transesophageal echocardiography: In this test, a doctor passes a narrow tube with a monitoring device into the person’s throat. The device uses sound waves to check for blood clots.
Treatment for AFib
Lifestyle changes
Lifestyle and dietary changes can boost heart health. A doctor
- a weight management plan
- increasing physical activity
- following a heart-healthy diet
- reducing stress or treating any mental health conditions
- quitting or avoiding smoking
- treating substance use disorders
Either a primary care physician or a cardiologist will explain how these strategies can help and may recommend follow-up tests at a later date to see how well they are working.
If a person has early stage AFib with a
Medication
Depending on the test results, a cardiologist may prescribe medications such as:
- beta-blockers to slow the rate at which the heart pumps blood through the body
- blood thinners to lower the risk of clots
- calcium channel blockers or other drugs to help manage irregular heart rhythms
- digoxin, which may be an option for people who do not tolerate other drugs well
If a person does not tolerate other drugs well, digoxin or amiodarone may be options. However, these drugs are
Procedures and surgery
If lifestyle changes and medication do not help a person with AFib, or there is a severe risk, a cardiac surgeon may carry out one or more of the following procedures:
- electrical cardioversion, which uses small shocks to restore heart rhythm
- cardiac ablation, which destroys tissues that are causing AFib
- a pacemaker to reduce AFib that results from a slow heartbeat
- plugging, closing, or cutting off a small part of the heart to prevent clotting
- a Maze procedure, which aims to restore heart rhythm by creating scar tissue in part of the heart
For some people, cardiac ablation is more appropriate and effective than drugs. Guidelines from the
People can find an AFib doctor by asking their primary care physician for a recommendation or using a cardiologist registry to find a doctor of their choosing.
The cost of AFib diagnosis and treatment will depend on various factors, such as:
- where the person lives
- which doctor they see
- the cause of AFib
- how severe it is
- what type of treatment they need
Both Original Medicare and Medicare Advantage plans help to pay for AFib diagnosis and treatment, but the out-of-pocket costs may differ.
There are several types of doctors and other medical personnel that can diagnose and treat AFib. People with early stage AFib may only need to see a primary care physician. People who need further tests and treatment will need a cardiologist.
Some people with AFib may also speak with a specialist cardiologist, such as a cardiovascular surgeon, an electrophysiologist, or a pediatric cardiologist if the patient is a child.