Silent AFib: The Heart Rhythm You Can’t Feel
You can have atrial fibrillation, or AFib, and never know it. Silent AFib occurs when the heart beats irregularly without causing noticeable symptoms, such as fluttering, fatigue, or shortness of breath.
Because it doesn’t cause discomfort or obvious warning signs, silent AFib often goes undetected until a routine exam, smartwatch alert, or heart-related event like a stroke. The earlier it’s found, the more options you have to protect your heart health, which makes awareness and prevention essential.
What is silent AFib?
AFib is one of the most common types of heart rhythm disorders. It happens when the heart’s electrical system causes the upper chambers (atria) to beat irregularly or out of sync with the lower chambers (ventricles). In some people, this irregular rhythm causes noticeable symptoms. In others, it happens quietly — a condition known as silent AFib.
These unnoticeable rhythm changes may come and go or be constant, but because many people don’t even realize they’re happening, they often go undiagnosed.
Even without symptoms, the heart is still under extra strain during these episodes. Over time, that added stress can affect how efficiently the heart pumps and increase the risk of complications like stroke or heart failure.
Who is most at risk?
Silent AFib can occur at any age, but it’s more common in people who:
- Are 65 or older
- Have high blood pressure, diabetes, or heart disease
- Live with sleep apnea or obesity
- Have a family history of arrhythmias or stroke
Because these same factors often exist without symptoms, routine screenings play an important role in prevention.
How it’s detected
Even without symptoms, silent AFib can often be detected through:
- Routine checkups, during which your provider listens for irregular rhythms or performs an EKG
- Heart monitors or smartwatches, which can flag irregular pulse patterns
- Echocardiograms or other imaging tests, which may be ordered if your physician suspects AFib
If you’re in a higher-risk group, your cardiologist may recommend additional monitoring to catch irregular rhythms early.
Why it matters
A lack of symptoms doesn’t mean a lack of risk. Silent AFib can cause the same complications as symptomatic AFib, including stroke, heart failure, and other heart-related issues.
When the heart beats irregularly, blood can pool in the upper chambers and form clots. If a clot travels to the brain, it can cause a stroke. In fact, AFib increases stroke risk by up to five times, and many AFib-related strokes happen in people who didn’t know they had the condition.
Early detection and treatment significantly reduce that risk.
Treatment and prevention
Once diagnosed, silent AFib is managed the same way as other forms of AFib — by controlling heart rate or rhythm and reducing the risk of clots.
Treatment may include:
- Medications like anticoagulants and rate or rhythm control drugs
- Lifestyle adjustments, such as improving sleep, managing stress, reducing alcohol intake, and maintaining a healthy weight
- Procedures like ablation, if medications alone aren’t enough to control the rhythm
- The goal is to keep the heart steady and prevent complications before they occur.
Supporting your heart health
Silent AFib may not cause symptoms, but it still requires attention and care. Routine checkups and open communication with your primary care physician or your cardiologist can help ensure early detection and reduce complications.
At the Oklahoma Heart Hospital’s Heart Rhythm Institute, we specialize in identifying and treating all forms of AFib, including those you can’t feel. If you’re at risk or want to learn more about silent AFib, schedule an appointment with our team. We’re here to help your heart stay steady and strong.