"This book is incredibly complete and easy-to-understand for anybody. I certainly recommend it for patients who want to know more about atrial fibrillation than what they will learn from doctors...."

Pierre Jaïs, M.D. Professor of Cardiology, Haut-Lévêque Hospital, Bordeaux, France

"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su Cavanaugh Heart Center, Phoenix, AZ

"Your book [Beat Your A-Fib] is the quintessential most important guide not only for the individual experiencing atrial fibrillation and his family, but also for primary physicians, and cardiologists."

Jane-Alexandra Krehbiel, nurse, blogger and author "Rational Preparedness: A Primer to Preparedness"


"Steve Ryan's summaries of the Boston A-Fib Symposium are terrific. Steve has the ability to synthesize and communicate accurately in clear and simple terms the essence of complex subjects. This is an exceptional skill and a great service to patients with atrial fibrillation."

Dr. Jeremy Ruskin of Mass. General Hospital and Harvard Medical School

"I love your [A-fib.com] website, Patti and Steve! An excellent resource for anybody seeking credible science on atrial fibrillation plus compelling real-life stories from others living with A-Fib. Congratulations…"

Carolyn Thomas, blogger and heart attack survivor; MyHeartSisters.org

"Steve, your website was so helpful. Thank you! After two ablations I am now A-fib free. You are a great help to a lot of people, keep up the good work."

Terry Traver, former A-Fib patient

"If you want to do some research on AF go to A-Fib.com by Steve Ryan, this site was a big help to me, and helped me be free of AF."

Roy Salmon Patient, A-Fib Free; pacemakerclub.com, Sept. 2013

 FAQs Coping with A-Fib: Irregular, Not Rapid

FAQs A-Fib afib18. “Can I have A-Fib when my heart rate stays between 50-60 BPM? My doctor tells me I have A-Fib. I usually have episodes which last under an hour, but I don’t always have a rapid heart rate. Sometimes when I lie down to go to sleep, an episode comes on. When I check my heart rate, it’s irregular but not rapid.” 

In some cases it’s possible to have A-Fib and still have what appears to be a regular heart rate. Your atria can be fibrillating, even though your heart doesn’t beat rapidly. How can that be? When you take your pulse, you’re counting the beats of your ventricles, not your atria. So, your atria can be fibrillating, but your heart beat appears normal. 

When listening to your heart through a stethoscope—you’re listening to your ventricles, not your atria.

Let’s say, for example, that you have A-Fib and your left atrium is fibrillating (quivering, beating) around 300 times a second. But in your case, your AV Node circuitry may be functioning very well, like a gatekeeper, to minimize the rate at which your atrial A-Fib pulses affect your heart rate (i.e., ventricular beats).

In another instance, some people have “silent” A-Fib (A-Fib with no symptoms) and appear to be in normal sinus rhythm (NSR). Their Atrial Fibrillation may only be discovered when they have a routine physical exam that includes an EKG. We don’t know enough about silent A-Fib, but untreated, it can kill you. Many people who suffer strokes are later found to have silent A-Fib.

Older people sometimes can have a slower form of A-Fib which can look like normal sinus rhythm, but they still have symptoms such as fatigue-tiredness and difficulty with exertion. Some forms of Atrial Flutter (4:1 ratio or slower) may also look like a normal heart rhythm.

But for most patients, their Atrial Fibrillation appears as an irregular and faster heart rate.

Thanks to Walt and Jim Ward for this question.

Back to FAQs: Coping with Your A-Fib

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