Symptoms:

You may not be aware that your heart is not beating in a normal pattern, especially if it has been occurring for some time.

Symptoms may include:

• Breathing difficulty while lying down
• Confusion
• Dizziness, light-headedness
• Fainting
• Fatigue
• Pulse that feels rapid, racing, pounding, fluttering, or too slow
• Pulse that feels regular or irregular
• Sensation of feeling the heart beat (palpitations)
• Sensation of tightness in the chest
• Shortness of breath

Note: Symptoms may begin or stop suddenly.

Signs and tests:

The health care provider may hear a fast heartbeat while listening to the heart with a stethoscope. The pulse may feel rapid, irregular, or both. The normal heart rate is 60 - 100, but in atrial fibrillation/flutter the heart rate may be 100 - 175. Blood pressure may be normal or low.

An ECG shows atrial fibrillation or atrial flutter. Continuous ambulatory cardiac monitoring -- Holter monitor (24 hour test) -- may be necessary because the condition often occurs at some times but not others (sporadic).

Tests to find underlying heart diseases may include:

• Coronary angiography
• Echocardiogram
• Electrophysiologic study (EPS)
• Exercise treadmill ECG
• Nuclear imaging tests