Atrial Fibrillation: What Women Need to Know

Atrial fibrillation may cause different health risks, outcomes in women than men

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

Heart rhythm disorders affect more than 2 million Americans. The most common of these disorders is atrial fibrillation (AFib) — and it may affect women differently than men.

Although both men and women can develop AFib, women may face an increased risk of stroke and heart attack. Anumeha Tandon, MD, a cardiologist with the Baylor Heart and Vascular Hospital in Dallas, told dailyRx News why this is.

"Women’s blood [is] more likely to clot as compared to men’s, just because of certain clotting factors present in our blood," Dr. Tandon said. "Women take estrogen supplements, especially after menopause, and we’ve known ... that that causes and predisposes them to cause clots.”

According to Dr. Tandon, doctors recently revised the risk scoring system for stroke related to AFib to include gender.

Atrial Fibrillation Basics

The heart has four chambers, which contract to move blood through the body. The upper two are smaller chambers called the atria.

The heart’s electrical system sends out signals that tell the heart when and how fast to beat. In AFib, these signals become erratic. Instead of beating properly, the atria quiver, or "fibrillate."

This disorder affects the body's circulatory system because the fibrillation isn’t strong enough to pump the blood properly.


Not all women with AFib experience symptoms. However, according to Dr. Tandon, women have more symptoms of AFib than men.

The most common of these symptoms are heart palpitations. Patients often describe these as a feeling like the heart is fluttering or flopping in the chest.

Some women complain of fatigue. Others feel dizzy or faint. AFib can also cause chest pain or shortness of breath.

Risk Factors

There are a number of risk factors for AFib, but the first is simply getting older. Although younger women can develop AFib, most women are diagnosed with the condition in their 60s and 70s.

Dr. Tandon pointed out that, on average, women live longer than men, which increases their risk.

Obese patients and patients with heart conditions also have a higher risk of developing AFib. Drinking alcohol heavily, smoking and consuming too much caffeine ups this risk.

Other diseases, such as diabetes, overactive thyroid, high blood pressure and sleep apnea, also increase the risk for AFib.

Additional risk factors for AFib in women may include high blood pressure, high cholesterol, migraine headaches, and using oral contraceptives or hormone replacement therapy.

Many of these risk factors also apply to heart attack and stroke.

AFib, Stroke and Heart Attack

According to the National Coalition for Women with Heart Disease, a woman with AFib is five times more likely to experience stroke than a woman without the condition.

An April 2015 article published in the journal Circulation looked at the risk of heart attack in women with AFib. These women were found to be 63 percent more likely to have a heart attack than women without the condition.

Reduce Your Risks

You can help reduce your risk of AFib, heart disease and stroke by maintaining a healthy weight, managing your stress and getting regular physical exercise.

If you have other conditions, such as diabetes or high blood pressure, it's also important to work with your doctor to keep them under control.

Some women need special treatment to get the heart back in rhythm, such as a cardioversion, which provides an electrical shock to restore a normal rhythm.

Some doctors also recommend treating AFib with medications to make the blood less likely to clot. These medicines, called anticoagulants, can also help prevent stroke.

According to Dr. Tandon, women need to be aware of their increased risk of heart attack and stroke to protect themselves as much as possible.

"Just being aware that the stroke rate is higher in women is obviously very important," Dr. Tandon said. "And talking to their doctors about when to start anticoagulant therapy can reduce the risk of AFib. Women age 65 and above and with one risk factor, such as high blood pressure, would qualify for blood-thinning therapy."

In an Emergency

Because AFib increases the risk of stroke and heart attack, it's important to know the signs of both.

Sudden numbness or weakness in the face or extremities, confusion, difficulty speaking, balance problems or a severe headache can all signal stroke. Chest pain, shortness of breath, or pain in the arms and neck may signal a heart attack.

Nausea, vomiting, and a sense of panic or agitation can also occur with either of these emergencies.

If you notice any of these symptoms, seek emergency medical care.

Review Date: 
September 1, 2015