Things to Know When You Are Diagnosed With AFib, With Jennifer Carlquist, PA-C, ER CAQ

In an interview with The Educated Patient, Jennifer Carlquist, PA-C, ER CAQ, breaks down what patients need to know when they’re first diagnosed with atrial fibrillation (AFib) — a common heart rhythm disorder that can lead to serious complications if untreated.

First and foremost, Carlquist emphasizes that AFib significantly increases the risk of stroke, so the initial step after diagnosis is to assess stroke risk using the CHA₂DS₂-VASc score. If the score is elevated, most patients will need to start anticoagulation (blood thinner) therapy. There are several medication options, from warfarin (Coumadin), which requires frequent monitoring, to newer treatments that are more convenient but can be more expensive.

Next, she stresses the importance of understanding why AFib occurred. Common causes include age; alcohol use; untreated sleep apnea; valve disease; and even infections such as sepsis, flu, respiratory syncytial virus or COVID-19. Identifying the trigger helps guide treatment and prevent recurrence.

Carlquist also notes that about 30% of people with AFib have no symptoms — so a normal-feeling heartbeat doesn’t always mean the rhythm is normal. Left untreated, AFib can lead to heart failure, which makes early and active management crucial.

Once diagnosed, patients can expect additional testing, including an echocardiogram (to assess heart structure and function) and possibly a stress test to rule out blocked arteries. Visits tend to be lengthy as providers collect this data and tailor therapy.

Finally, Carlquist reassures patients that AFib can often be treated or even reversed. Early interventions — like cardioversion (a mild electric shock to reset the heart rhythm) or ablation procedures — can restore normal rhythm. “AFib begets AFib,” she says, meaning that the longer it persists, the harder it is to fix — so swift, coordinated care is key.

5 Things to Know When You Are Diagnosed With AFib

• You are at increased risk for stroke — blood thinners are usually necessary.
• Your care team will investigate why AFib happened (age, alcohol, sleep apnea, infection, etc.).
• Some people have no symptoms, so monitoring is essential.
• Follow-up tests like echocardiograms and stress tests help tailor treatment.
• Treating AFib early can prevent long-term heart changes — ask about cardioversion or ablation.