Without treatment, atrial fibrillation (A-fib) can lower a person’s life expectancy due to the risk of serious complications. However, with proper treatment, people with A-fib can often lead long, healthy lives.

Heart rhythm involves a synchronized pumping action, or beating, of the four chambers of the heart.

Irregular heart rhythms, or arrhythmias, occur when electrical signals that coordinate the heartbeat do not work properly. This can cause the heart to have an irregular and erratic rhythm.

A-fib is the most common type of irregular heart rhythm. It happens when the heart’s upper chambers, or atria, quiver due to irregular electrical activity.

Around 2.7 million people in the United States have A-fib, which results in 158,000 deaths every year.

This article explores the outlook and life expectancy of a person with A-fib. It also discusses the complications of A-fib, how doctors treat the condition, and ways to prevent it.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Research suggests that the outlook for people with A-fib has improved over time, but people without A-fib generally have better life expectancies than those with the condition. A person’s outlook and life expectancy depend on individual factors.

A-fib in itself may not be life threatening. Its effect is highly dependent on risk factors and the presence of comorbidities, which include:

  • a person’s age and sex
  • other health conditions
  • the severity of A-fib
  • its response to treatment

It can also lead to serious complications that can be fatal. Mortality rates are four times higher in people with A-fib than in the general population.

Sex, symptom presentation, and age

Females with A-fib have a poorer outlook than males, with a higher incidence of stroke and death from heart failure and stroke.

The outlook is the same regardless of whether a person experiences symptoms or not. However, a person without symptoms may not receive an early diagnosis of A-fib and therefore experience a delay in treatment.

Older people are at a higher risk of developing A-fib. However, studies show an increasing trend of deaths in young adults. Experts suggest this is due to the growing rate of various conditions among younger people, which include:

Comorbidities

Comorbidities, or accompanying conditions, play a role in the progression of A-fib and the development of complications. A 2015 study found that comorbidities such as hypertension and diabetes significantly negatively affect the life expectancy of a person with A-fib.

A-fib occurs in 25% of people with heart failure. People with both conditions have worse symptoms and a poorer outlook.

People with A-fib have a five-fold risk of stroke, which is the most common cause of death in people with A-fib.

A 2017 study found that those with A-fib and diabetes had a higher risk of death and heart failure than people with stroke.

Healthcare professionals may aim to prevent thromboembolism to improve the outlook of people with A-fib. Thromboembolism is when a blood clot forms and blocks a blood vessel.

Learn more about the difference between thrombosis and embolism.

A doctor may prescribe anticoagulant medications that prevent blood clots from forming and improve the outlook of people with A-fib. However, over half of the people with A-fib are not on antithrombotic treatment. Anticoagulant drugs are a type of antithrombotic treatment.

Research also indicates that 60% of strokes from A-fib are avoidable when people use blood thinners, another term for anticoagulant medication.

A 2022 study found that people receiving early heart rhythm control treatment, such as antiarrhythmic drugs, had a lower risk of adverse cardiovascular outcomes. However, this treatment may benefit younger individuals more than those over 75 years old.

A-fib causes the upper and lower chambers of the heart to become uncoordinated. The irregular rhythm may cause blood to pool in the heart. This may lead to blood clots that can break free, travel, and lodge in an artery in the brain and cause stroke. A blood clot may also travel to another organ and cause other complications.

A-fib increases a person’s stroke risk by about 4–6 times. Strokes caused by A-fib are often more severe than those caused by other underlying causes.

People with A-fib may have an irregular and fluttery heartbeat that prevents the lower heart chambers from filling completely. When this happens, the heart may not pump enough blood to the lungs and the rest of the body, leading to heart failure.

Aside from stroke and heart failure, A-fib is a major cause of sudden death and cardiovascular diseases.

A person with A-fib may improve their outlook with appropriate treatment. The primary goals of A-fib treatment are to prevent blood clots and restore a person’s natural heart rhythm and rate.

A doctor will decide on the most appropriate treatment for someone based on individual factors, such as:

Lifestyle changes

Doctors may recommend a person adopts healthy lifestyle changes to reduce their risk of complications associated with A-fib. These may include:

Medications

Several medications can also help with A-fib by preventing and treating blood clots and managing the heart’s rate and rhythm.

Medication options may include:

  • anticoagulant drugs to reduce the risk of blood clots and stroke
  • medications that slow down the heart rate, such as beta-blockers and calcium channel blockers
  • rhythm control medications to treat the heart’s irregular rhythm, such as sodium and potassium channel blockers

Learn more about A-fib medications.

Procedures or surgery

The doctor may recommend a procedure if lifestyle changes and medications do not improve a person’s symptoms. These may include:

The American Heart Association identified seven modifiable risk factors, which are a combination of health and behavior factors that a person should avoid to prevent A-fib. It suggests:

  • managing high blood pressure
  • stopping smoking
  • maintaining a moderate weight
  • exercising regularly
  • preventing and managing diabetes
  • managing cholesterol levels
  • adopting a healthy diet

A-fib may not be a life threatening condition by itself, but without treatment, it can affect a person’s life expectancy due to the increased risk of complications such as stroke and heart failure.

A person may make lifestyle changes and take medications to manage the condition and prevent further complications. A doctor may suggest a person has surgery or other procedures if lifestyle changes and medications do not improve a person’s outlook.