Understanding Atrial Fibrillation: A Common Heart Rhythm Problem Primary Care Doctors Treat
Understanding Atrial Fibrillation: A Common Heart Rhythm Problem Primary Care Doctors Treat
When most people think of heart problems, they think of blocked arteries or heart attacks. But there's another common, serious heart condition that we often diagnose and manage right here in primary care: Atrial Fibrillation, or AFib. At Florida Direct Primary Care in St. Augustine, FL, we’re committed to helping our patients understand and manage conditions like AFib before they lead to serious complications.
In this post, I’ll explain what atrial fibrillation is, why it matters, how common it is, and how we treat and monitor it effectively in a primary care setting.
What Is Atrial Fibrillation?
Atrial fibrillation is a type of arrhythmia, or irregular heartbeat. In AFib, the heart’s upper chambers (the atria) beat rapidly and chaotically, out of sync with the lower chambers (the ventricles). Instead of a normal, regular rhythm, the heartbeat becomes disorganized, often fast and unpredictable.
You might feel it as:
A fluttering or pounding in the chest
Fatigue
Lightheadedness or dizziness
Shortness of breath
Chest discomfort
However, some people with AFib have no symptoms at all. That’s one reason why regular checkups and listening to your heart are so important.
Why Is Atrial Fibrillation Important?
AFib isn’t just a nuisance—it’s a major risk factor for serious health problems, especially stroke. Because the atria don’t contract properly in AFib, blood can pool and form clots. If one of those clots travels to the brain, it can cause a stroke.
In fact, atrial fibrillation increases your risk of stroke by five times. These strokes tend to be more severe and disabling than strokes from other causes.
Other complications include:
Heart failure, from the heart pumping inefficiently over time
Cognitive decline or dementia
Reduced quality of life due to fatigue, dizziness, or anxiety
That’s why early diagnosis and proactive management of AFib is crucial.
How Common Is Atrial Fibrillation?
AFib is the most common sustained arrhythmia in adults. According to the CDC:
Over 5 million Americans have AFib.
By 2030, that number is expected to rise to over 12 million.
The risk increases with age—9% of people over 65 are affected.
It’s also more common in people with:
High blood pressure
Heart disease
Diabetes
Sleep apnea
Thyroid disease
Obesity
Excessive alcohol use
Because of how common AFib is—and because its symptoms are sometimes subtle—it’s something we routinely screen for at Florida Direct Primary Care.
How Is Atrial Fibrillation Diagnosed?
In many cases, AFib is detected during a routine exam, when we hear an irregular heartbeat. We confirm the diagnosis with an electrocardiogram (EKG), a painless test that records your heart’s electrical activity. This is something we can do right in our office, at no additional charge for our patients.
Sometimes we need longer-term monitoring:
Holter monitors (worn for 24–48 hours)
Event monitors (worn for several weeks or implantable devices for months)
Or even smartwatches that detect irregular rhythms
At Florida Direct Primary Care in St. Augustine, we partner with cardiologists for specialized testing when needed, but many cases can be managed right here in our office.
What Are the Treatment Options for AFib?
Treatment for atrial fibrillation focuses on three main goals:
Preventing strokes
Controlling heart rate or rhythm
Improving symptoms and quality of life
1. Stroke Prevention with Blood Thinners
This is often the most important step. We use a risk calculator called CHA₂DS₂-VASc to estimate stroke risk based on age and medical history.
Patients with moderate to high risk are started on anticoagulants, or blood thinners, such as:
Apixaban (Eliquis)
Rivaroxaban (Xarelto)
Dabigatran (Pradaxa)
Warfarin (Coumadin)
These medications significantly reduce the risk of stroke but come with bleeding risks, so we carefully monitor and individualize the choice for each patient.
2. Rate vs. Rhythm Control
Some patients do well with rate control—slowing the heartbeat down without necessarily restoring a normal rhythm. Others benefit from rhythm control, using medications or procedures to restore and maintain a regular heartbeat.
Rate control medications include:
Beta-blockers (like metoprolol)
Calcium channel blockers (like diltiazem)
Rhythm control might involve:
Antiarrhythmic drugs (like amiodarone or flecainide)
Electrical cardioversion (a controlled shock to reset the rhythm)
Catheter ablation (a procedure done by a cardiologist to destroy small areas of heart tissue causing the arrhythmia)
At our practice, we help patients understand their options and coordinate care with cardiology and electrophysiology specialists when advanced procedures are needed.
3. Improving Symptoms and Quality of Life
Even if AFib isn’t life-threatening in the moment, the symptoms can significantly affect how you feel day to day. Many patients describe feeling constantly tired, short of breath, or anxious. One of our top priorities at Florida Direct Primary Care is to help patients not just live longer—but live better.
Managing symptoms and improving quality of life involves a personalized, whole-person approach, including:
Medication Adjustment
If medications to control your heart rate or rhythm are causing fatigue, dizziness, or side effects, we’ll work with you to find alternatives or adjust the dose. Sometimes a small change makes a big difference in how you feel.
Lifestyle Support
We provide ongoing support for:
Physical activity tailored to your tolerance and goals
Nutrition to support heart health and stable energy
Weight management, which has been shown to reduce AFib burden
Limiting alcohol and caffeine, which can trigger episodes in some people
Stress Reduction
Mental and emotional stress can worsen AFib symptoms. We often recommend relaxation techniques like:
Deep breathing exercises
Yoga or tai chi
Counseling or therapy for anxiety related to AFib
Mindfulness-based stress reduction
Sleep Quality
Poor sleep—and especially sleep apnea—can make AFib harder to control. We screen patients for signs of sleep apnea and, if needed, refer for sleep studies and CPAP treatment, which can dramatically reduce AFib episodes and improve energy.
Can Atrial Fibrillation Be Cured?
In some cases—especially when AFib is caused by a reversible condition like hyperthyroidism or alcohol use—it may go away once that condition is treated.
However, most patients will need long-term monitoring and management. Fortunately, with today’s treatments, most people with AFib can live full, active lives.
How We Monitor and Manage AFib at Florida Direct Primary Care
As a direct primary care practice in St. Augustine, we’re uniquely positioned to offer personalized, accessible, and continuous care for AFib.
Our approach includes:
Regular EKGs and pulse checks at office visits
Regular risk assessment for stroke and bleeding
Medication monitoring for effectiveness and side effects
Lifestyle coaching for diet, exercise, and stress
Sleep apnea screening, which can worsen AFib
Easy access to Dr. Wilson by phone, text, or same-day appointments
Because we don’t bill insurance for every visit or test, we can focus on what matters: keeping you well and preventing complications. That means more time to answer questions, adjust treatments, and keep an eye on your long-term heart health.
Lifestyle Tips to Reduce AFib Symptoms
In addition to medical therapy, several lifestyle changes can reduce the frequency and severity of AFib episodes:
Limit alcohol (especially binge drinking)
Reduce caffeine if sensitive
Quit smoking
Treat high blood pressure and sleep apnea
Exercise regularly, but avoid overexertion
Manage stress with mindfulness or relaxation techniques
These are all things we help you implement in a sustainable, realistic way in our St. Augustine, FL office.
When Should You See a Doctor?
If you’ve experienced:
A racing or irregular heartbeat
Dizziness or fainting
Chest discomfort
Shortness of breath
Or if you’re over 65 and haven’t had a recent heart check-up
…it’s worth scheduling an appointment for an evaluation.
Final Thoughts
At Florida Direct Primary Care, we believe in proactive care and strong doctor-patient relationships. Atrial fibrillation doesn’t have to take over your life—with the right care plan, you can stay in control.
Whether you’ve been diagnosed with AFib, have risk factors, or simply want to stay ahead of heart disease, we’re here for you every step of the way.
Florida Direct Primary Care in St. Augustine
Dr. Bryant Wilson is a board certified internal medicine physician at Florida Direct Primary Care who develops individualized treatment plans that promote overall health and wellness, tailored to each patient’s unique health needs and goals. If you’re in the St. Augustine area and looking for a primary care doctor, contact us to learn more about our practice. Visit FloridaDPC.com, email us at info@FloridaDPC.com, or call 904-650-2882.
This web site is provided for educational and informational purposes only and does not constitute the provision of medical advice or professional services. The information provided should not be used for diagnosing or treating individual health problems or diseases. Those seeking medical advice should consult with a licensed physician.Ready to become a Florida DPC member? Click here to register.
