Atrial fibrillation is the most common heart rhythm disorder. Instead of contracting evenly, the atria beat in an uncontrolled and usually too rapid way. The result: blood is no longer pumped through the heart as efficiently as in a normal rhythm.¹
Atrial fibrillation is widespread in Germany and is one of the most common reasons for cardiology consultations. The risk rises markedly with age.¹˒⁴
2. Symptoms
Symptoms vary widely — some people clearly feel their atrial fibrillation, while others barely notice it or not at all:¹
Palpitations or a stumbling heartbeat — irregular pulse
Tricky: silent atrial fibrillation
Many people do not feel their atrial fibrillation. It is then often only discovered during a medical examination or — in the worst case — after a stroke.
3. Why is atrial fibrillation dangerous?
The main risk is stroke. Because of the irregular blood flow, blood clots can form in the atria. If a clot breaks loose, it can travel to the brain and block a blood vessel there. Without suitable blood thinning, the stroke risk in atrial fibrillation is significantly increased.¹˒⁴
In addition, atrial fibrillation can weaken the heart's performance over the long term and worsen existing heart conditions (e.g. heart failure).
Signs of a stroke — call emergency services immediately!
Sudden one-sided paralysis or weakness · speech or language-comprehension difficulty · visual disturbance or double vision · sudden severe headache · dizziness or unsteady gait. If you notice these signs, call the emergency number 112 immediately — every minute counts.
4. Causes and risk factors
High blood pressure — considered the most common cause
Heart valve disease
Coronary heart disease, heart failure
Overactive thyroid — have the thyroid checked with every newly occurring AF episode
ECG: The gold standard — shows the irregular rhythm directly. However, paroxysmal atrial fibrillation is often not captured by a resting ECG.
Long-term ECG: Recording over one to several days. Also captures paroxysmal atrial fibrillation that was not visible on a resting ECG.
Smartwatch/wearable: Can provide indications of atrial fibrillation — but does not replace a medical ECG diagnosis. If an alert occurs, you should usually consult a cardiologist.
Echocardiography: Ultrasound of the heart — assesses the size of the atria, the pumping function and possible valve defects.
For most patients with atrial fibrillation, permanent blood thinning is necessary. The individual risk is calculated using the CHA₂DS₂-VASc score.⁴
DOACs (direct oral anticoagulants) — today's standard
Apixaban, rivaroxaban, edoxaban and dabigatran. Easier to handle than vitamin K antagonists — usually no regular coagulation checks needed. More: Blood thinners in everyday life.
Vitamin K antagonists — phenprocoumon (Marcumar/Falithrom)
Older drug class. The INR value must be checked regularly. Many interactions with foods and other medications.
Never stop blood thinners on your own!
Otherwise the stroke risk rises significantly. Before dental appointments or minor procedures too: always consult your doctor first.
Lower the heart rate and are considered first choice for most patients.
Calcium channel blockers — verapamil, diltiazem
Alternative if beta-blockers are not tolerated.
Digitalis — digoxin
Used as an add-on, often with accompanying heart failure.
Goal 3Rhythm control — restoring a normal heart rhythm
Flecainide
In certain cases it can also be used as an on-demand medication for paroxysmal atrial fibrillation — the decision is always made by the cardiologist.
Amiodarone
Considered one of the most effective rhythm medications, but it has a relevant side-effect profile (incl. thyroid, lungs, liver). It is usually only used for atrial fibrillation that is difficult to treat.
The heart rhythm is reset to a normal sinus rhythm by a controlled electrical impulse under brief anesthesia. Usually an outpatient procedure.
Catheter ablation (pulmonary vein isolation)
A minimally invasive procedure in which a catheter is guided to the heart via the groin. Incorrectly firing electrical signals are specifically obliterated (pulmonary vein isolation). Particularly effective for paroxysmal atrial fibrillation and in younger patients. In a relevant proportion of those treated, atrial fibrillation can be eliminated or significantly reduced in the long term.⁴
8. Living with atrial fibrillation
Measure your pulse: Regularly — at the wrist or with a smartwatch. Inform your cardiologist if your pulse is irregular.
Blood thinners: Take them punctually and regularly. Inform your doctor in case of injuries or bleeding. Always carry your medication pass.
Alcohol: Can trigger or worsen atrial fibrillation. In most cases, largely avoiding it or at least clearly reducing consumption is advisable. More: Medications and alcohol.
Sport: Moderate exercise is usually recommended (e.g. swimming, cycling, walking). For extreme or high-performance sport: individual consultation with your cardiologist.
Concomitant conditions: Consistently treat blood pressure, diabetes and overweight — this can usually reduce the frequency and severity of atrial fibrillation episodes.
How brite helps you with atrial fibrillation
Blood thinners on time, never forgetting heart medications, checking interactions — with atrial fibrillation, reliability is especially important.
Intake reminder — blood thinners, beta-blockers, rhythm medications: taking them on time is especially important for heart medications. Set up a reminder
Interaction check — blood thinner + painkiller? + antibiotics? Check interactions for free. Check now
Health history — document pulse, heart rhythm episodes and symptoms. Track your history
Digital medication plan — all heart medications clearly organized for cardiology and emergency doctors. Go to medication plan
Without treatment, atrial fibrillation can significantly increase the stroke risk. With suitable blood thinning and treatment, however, the condition is usually well controllable, and most people affected can lead a largely normal life.¹˒⁴
For most patients with atrial fibrillation, permanent blood thinning is usually recommended. The individual risk is calculated using the CHA₂DS₂-VASc score. The decision is always made by the treating cardiologist.⁴
A minimally invasive procedure in which incorrectly firing electrical signals in the heart are specifically obliterated (pulmonary vein isolation). In a relevant proportion of those treated, atrial fibrillation can be eliminated or significantly reduced in the long term. The chances of success depend, among other things, on the form of atrial fibrillation and individual factors.⁴
Yes — moderate exercise is usually even recommended (e.g. swimming, cycling, walking). For extreme or high-performance sport, you should consult your cardiologist.
Modern smartwatches can provide indications of atrial fibrillation. However, they do not replace a medical ECG diagnosis. If an alert occurs, you should usually consult a cardiologist.
Deutsche Herzstiftung: Vorhofflimmern — Informationen und Ratgeber. herzstiftung.de
Deutsches Herzzentrum der Charité (DHZC): Vorhofflimmern. dhzc.charite.de
Deutsche Herzstiftung: Medikamente bei Vorhofflimmern. herzstiftung.de
ESC Guidelines: Management of Atrial Fibrillation (2024). escardio.org
Medical disclaimer: This article is for general information and does not replace medical advice, diagnosis or treatment. Blood thinners should never be stopped on your own — this can significantly increase the stroke risk. If you notice signs of a stroke (sudden one-sided paralysis, speech disturbance, visual disturbance), call the emergency number 112 immediately. The choice of medication and dosage is always determined individually by the treating cardiologist. Last updated: April 2026.
