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Cardiolucent

Condition

Atrial fibrillation

Conditions

Atrial fibrillation (AFib) is the most common sustained heart rhythm disorder, affecting millions of adults and rising sharply with age. In AFib, the upper chambers of the heart quiver chaotically rather than contracting in a coordinated way, which both reduces the heart's pumping efficiency and allows blood to pool — a setup for clot formation and stroke. Many patients feel palpitations, breathlessness, or fatigue, but a substantial share have no symptoms at all and learn of the diagnosis only through a wearable device or routine EKG. Regardless of symptoms, the stroke risk remains, which is why timely diagnosis, accurate risk scoring, and a thoughtful rhythm strategy are central to long-term outcomes. Dr. Kedan manages AFib as both an electrical problem and a metabolic one, addressing the upstream drivers that make recurrence likely.

What Cardiolucent Evaluates

  • 12-lead EKG and extended ambulatory monitoring (2-week patch or longer when needed) to confirm and quantify burden
  • Echocardiography with POCUS to assess left atrial size, valve function, and ventricular performance
  • CHA2DS2-VASc and HAS-BLED scoring for personalized stroke and bleeding risk
  • Screening for reversible drivers: sleep apnea, thyroid disease, alcohol, hypertension, obesity
  • Thyroid function, kidney function, and electrolyte panel
  • Wearable and home data integration when available (Apple Watch, KardiaMobile, etc.)
  • Coordination with electrophysiology at Cedars-Sinai when catheter ablation or left atrial appendage closure is appropriate

Common Symptoms

  • Palpitations described as fluttering, pounding, racing, or irregular heartbeat
  • Fatigue or reduced exercise tolerance
  • Shortness of breath, especially with exertion
  • Lightheadedness or pre-syncope
  • Chest discomfort or pressure during episodes
  • Anxiety or a sense that something is wrong without a clear cause
  • Many patients (up to a third) have no symptoms at all
  • Stroke is sometimes the first manifestation of previously unknown AFib

Risk Factors

  • Age over 65, with prevalence rising steeply each decade thereafter
  • Hypertension, particularly when long-standing or poorly controlled
  • Obesity and visceral adiposity
  • Obstructive sleep apnea — present in a large share of AFib patients
  • Excess alcohol intake, especially binge patterns
  • Diabetes and metabolic syndrome
  • Valvular heart disease, heart failure, prior cardiac surgery, or cardiomyopathy
  • Hyperthyroidism
  • Endurance athletic history and family history of AFib

How Cardiolucent Approaches Treatment

Dr. Kedan treats AFib on three parallel tracks: stroke prevention, rate or rhythm control, and aggressive management of the upstream drivers. Anticoagulation selection is individualized using stroke and bleeding scores along with kidney function and concurrent medications. Rhythm strategy — rate control alone, antiarrhythmic medication, or catheter ablation coordinated with Cedars-Sinai electrophysiology — is matched to symptoms, atrial size, and AFib duration. Equally important is the upstream work: weight loss, sleep apnea treatment, blood pressure optimization, and alcohol reduction have all been shown to meaningfully reduce AFib burden and improve ablation success. The concierge model supports the close follow-up these adjustments require.

Common Questions

Frequently Asked Questions

What is atrial fibrillation?
Atrial fibrillation, or AFib, is the most common sustained heart rhythm disorder. Instead of contracting in a coordinated way, the upper chambers of the heart quiver chaotically, which can allow blood to pool and form clots. Those clots are the reason AFib substantially raises the risk of stroke, even in people who feel relatively well.
What does AFib feel like?
Some patients describe palpitations, a fluttering or pounding sensation in the chest, fatigue, shortness of breath, dizziness, or reduced exercise tolerance. Others have no symptoms at all and only learn of their AFib when it is found on an exam or wearable device. Both presentations carry stroke risk and deserve formal evaluation.
How is AFib diagnosed?
A 12-lead EKG confirms AFib when the rhythm is occurring at the time of recording. Because the arrhythmia often comes and goes, Dr. Kedan frequently uses extended ambulatory monitoring to capture it and quantify how often it occurs. Echocardiography is typically added to evaluate the heart's structure, valves, and chamber sizes, all of which inform the long-term plan.
How is my stroke risk calculated?
Stroke risk in AFib is estimated using the CHA2DS2-VASc score, which incorporates age, sex, blood pressure, diabetes, prior stroke, vascular disease, and heart failure. The score guides whether anticoagulation is recommended and which agent fits best. Dr. Kedan reviews the calculation with you so you understand both the rationale and the trade-offs of treatment.
Do I have to be on a blood thinner?
Anticoagulation is the most effective tool we have to prevent AFib-related stroke, and for most patients with meaningful risk it is strongly recommended. The newer direct oral anticoagulants are generally safer and more convenient than warfarin, though selection depends on kidney function, bleeding risk, and other medications. In select low-risk patients, anticoagulation may not be necessary, and Dr. Kedan reviews that calculus carefully.
Should I aim to control the rate or restore normal rhythm?
Both strategies are valid, and the right choice depends on your symptoms, age, heart structure, and how long AFib has been present. Rate control with medication is often sufficient for asymptomatic or minimally symptomatic patients. Rhythm control — through medication or catheter ablation — is favored for symptomatic patients, younger patients, and those with recent-onset AFib, with Dr. Kedan coordinating directly with electrophysiology when ablation is being considered.
Can lifestyle changes really help my AFib?
Yes, and the impact is often underestimated. Weight loss, treatment of sleep apnea, alcohol reduction, blood pressure control, and aerobic conditioning have all been shown to reduce AFib burden and improve the success of other therapies. These changes are not a substitute for stroke prevention, but they meaningfully shift the trajectory of the disease.
Is AFib life-threatening?
AFib itself is rarely immediately dangerous, but the stroke and heart failure risks it carries can be life-altering if unmanaged. With appropriate anticoagulation, rhythm or rate control, and risk-factor management, the vast majority of patients live full, active lives. Schedule a consultation with Dr. Kedan to put a clear plan in place.
How often should I be seen?
Most patients on a stable regimen are seen every 3–6 months, with more frequent visits during medication changes, after procedures, or when symptoms shift. POCUS at the office allows Dr. Kedan to reassess heart structure and function over time without sending you out for additional imaging.

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The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.