Cleveland Clinic Atrial Fibrillation Videos and Tool

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Take the Atrial Fibrillation Interactive Tool below

What Are Your Options?

This tool will provide you with a printout to take to your next doctor visit to help guide the discussion of the most appropriate treatment plan for your atrial fibrillation.

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Print these results and take them to your next doctor visit to help guide the discussion of the most appropriate treatment plan for your atrial fibrillation.

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When were you diagnosed with atrial fibrillation?

Question Answer Less than 1 year ago 1-5 years ago Over 5 years ago I don't know

Do you have persistent (continuous) atrial fibrillation?

Question Answer Yes No I don't know

How frequent are your atrial fibrillation episodes?

Question Answer Daily Weekly Monthly I don't know

How long do your episodes last?

Question Answer Minutes Hours Days I don't know

Do you have any of these symptoms?

Heart palpitations - Sudden pounding, fluttering or racing sensation in the chest
Lack of energy - Feeling over-tired or decreased ability to perform your daily activities
Dizziness - Feeling light-headed or faint
Chest discomfort - Pain, pressure or discomfort in the chest
Shortness of breath - Having difficulty breathing during normal activities and even at rest

Question Answer Yes No I don't know

Do you take medication for atrial fibrillation?

Question Answer Yes, I do for rate control (e.g. atenolol, diltiazem, metoprolol, nadolol, propranolol, verapamil) Yes, I do to maintain normal rhythm (e.g. amiodarone, dofetilide, dronedarone flecainide, propafenone, sotalol) No I don't know

Have you ever had a cardioversion?

Question Answer Yes No I don't know

After the cardioversion, how long did normal rhythm last?

Question Answer Less than 1 day A few weeks Over a month I am still in normal rhythm I don't know

Have you ever had an ablation for atrial fibrillation?

Question Answer Yes No I don't know

When did you have an ablation?

Question Answer Less than 6 months ago 6 to 12 months ago Over a year ago I don't know

After the ablation, how long did normal rhythm last?

Question Answer Less than 1 day A few weeks Over a month I am still in normal rhythm I don't know

Have you ever had surgery (i.e. Maze) for atrial fibrillation?

Question Answer Yes No I don't know

How long ago did you have surgery (i.e. Maze)?

Question Answer Less than 6 months ago 6 to 12 months ago Over a year ago I don't know

After the surgery (i.e. Maze) how long did normal rhythm last?

Question Answer Less than 1 day A few weeks Over a month I am still in normal rhythm I don't know

Do you have any of the following?

Coronary artery disease
Diabetes
Heart failure
History of stroke/TIA
Hypertension
Hypertrophic cardiomyopathy
ICD/Pacemaker
Open heart surgery
Valve disease
Congenital heart disease

Question Answer Yes No I don't know

Is your ejection fraction normal?

Question Answer Yes, it is greater .60 or 60% and/or my doctor said it was normal No, it is less than .60 or 60% and/or my doctor said it was not normal (or reduced) I don't know

Has your doctor talked to you about anticoagulation (blood thinner) medication?

Question Answer Yes No I don't know

Are you on any of the following anticoagulation medication?

Aspirin
Clopidogrel
Warfarin
Dabigatran

Question Answer Yes No I don't know

Thank you for completing the questionnaire.

Download and print your responses for your next doctor visit.

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Contact Us

If you have additional questions or would like to schedule a consultation, please contact our team of heart and vascular resource nurses weekdays from 8:30 a.m. to 4:30 p.m. (EST).

Toll-free: 1.866.585.9150

You may find the following resources helpful:

Learn more about diagnosis and treatment of Atrial Fibrillation: clevelandclinic.org/heart
Chat with a nurse: clevelandclinic.org/heartnursechat
Free online health chats: clevelandclinic.org/webchats

To obtain an evaluation by a Cleveland Clinic electrophysiologist: Call Toll-free: 1.866.585.9150

Request an appointment online: clevelandclinic.org/appointments
Online Second Opinion: eclevelandclinic.org

Cleveland Clinic Center for Atrial Fibrillation

Atrial Fibrillation Tool

What Are Your Options?

When were you diagnosed with atrial fibrillation?

Do you have persistent (continuous) atrial fibrillation?

How frequent are your atrial fibrillation episodes?

How long do your episodes last?

Do you have any of these symptoms?

Do you take medication for atrial fibrillation?

Have you ever had a cardioversion?

After the cardioversion, how long did normal rhythm last?

Have you ever had an ablation for atrial fibrillation?

When did you have an ablation?

After the ablation, how long did normal rhythm last?

Have you ever had surgery (i.e. Maze) for atrial fibrillation?

How long ago did you have surgery (i.e. Maze)?

After the surgery (i.e. Maze) how long did normal rhythm last?

Do you have any of the following?

Is your ejection fraction normal?

Has your doctor talked to you about anticoagulation (blood thinner) medication?

Are you on any of the following anticoagulation medication?

Thank you for completing the questionnaire.

Contact Us