Atrial Fibrillation Heart Rate vs Pulse Rate: Understanding the Difference

Atrial fibrillation (AFib) can cause a discrepancy between heart rate and pulse rate, although the exact difference varies depending on the situation. During an AFib episode, the heart's ventricles may beat very rapidly and irregularly. In such cases, the pulse rate measured at the wrist may significantly differ from the actual heart rate. This is because not every heartbeat effectively pumps blood through the arteries, leading to what is known as a "pulse deficit."

What Causes the Difference?

When the heart rate is extremely fast, the pulse may feel chaotic and difficult to measure accurately. This irregularity often indicates AFib. Therefore, simply measuring the pulse may not give an accurate representation of the heart rate during an AFib episode. Instead, it is more reliable to listen to the heart using a stethoscope for a full minute to determine the actual heart rate.

Chronic AFib and Medication Effects

In patients with long-term or permanent AFib, medications such as beta-blockers (e.g., Bisoprolol) are often prescribed to control ventricular rate. These medications can slow the heart rate, making the pulse rate closer to the heart rate, although the rhythm remains irregular. Despite this, the pulse may still feel uneven when touched, indicating the presence of AFib.

Why Accurate Measurement Matters

It's important to note that the difference between heart rate and pulse rate in AFib varies from person to person and depends on the severity and duration of the episode. As a result, it's not advisable to rely solely on pulse measurement to assess heart rate during AFib. Instead, medical professionals recommend using a stethoscope for a full 60 seconds to obtain an accurate heart rate reading.

When to Seek Medical Help

If you suspect you're experiencing AFib, it's crucial to seek immediate medical attention. A healthcare provider can perform an electrocardiogram (ECG) to confirm the diagnosis and determine the appropriate treatment. In some cases, intravenous medications may be necessary to restore a normal heart rhythm and prevent complications.