A Relationship Between Atrial Fibrillation and Dizziness

Q: What is the clinical evidence from this study?

Study design: Systematic Review. Population: Atrial fibrillation (n=2102). Intervention: Vertigo and dizziness in atrial fibrillation. Primary outcome: Symptom improvement of dizziness and vertigo with restoration of sinus rhythm.

Q: What does this research mean for the field?

Dizziness and vertigo are reported in up to 41.2% of atrial fibrillation patients and frequently improve with restoration of sinus rhythm or vestibular treatment. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

R Urs; Luigi Geo Marceanu; H. Rus; Alexandru Covaciu; Christian Gabriel Strempel; Elena Bobescu

doi:10.3390/jcm14197101

October 9, 2025Journal of Clinical MedicineOpen Access

A Relationship Between Atrial Fibrillation and Dizziness

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Key result

Sinus rhythm restoration resolves AF-related dizziness and vertigo in ~61% of patients.

n=2,102

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Key Points

To evaluate the relationship between vestibular symptoms and atrial fibrillation and to assess their role as potential early manifestations or triggers of the arrhythmia.
Conducted a systematic review of five studies evaluating vestibular manifestations in 2102 patients with atrial fibrillation (55.4% men, 44.6% women; mean age 65.5 years in women and 66.7 years in men).
Assessed clinical presentations, symptom clustering, cardiac monitoring, and therapeutic interventions across acute and outpatient settings.
Dizziness was documented in up to 41.2% of patients with atrial fibrillation, frequently clustering within cardiac or asthenic symptom groups rather than being recognized as a primary symptom.
In acute vestibular neuritis presentations, severe vertigo preceded or coincided with atrial fibrillation onset, accompanied by ventricular responses ranging from 100 to 155 bpm.
Dizziness and vertigo improved in 60.7% of patients upon restoration of sinus rhythm and in 27.2% following treatment of the underlying vestibular disorder.

Study Design

Type

Systematic Review (n=2,102)

Structured PICO

P

Population

2,102 adults (aged 32-89 years, 44.6% female) with newly diagnosed atrial fibrillation and no baseline AF history across five included studies evaluating vestibular symptoms.

E

Exposure

Various management strategies for atrial fibrillation and vestibular symptoms across included studies, including beta-blockers, antiarrhythmics, calcium channel blockers, anticoagulants, radiofrequency ablation (up to 52% in one study), oxygen therapy, and corticosteroids/vestibular suppressants (for acute vestibular neuritis).

O

Outcome

Presence and clinical characteristics of vestibular symptoms (vertigo or dizziness) in relation to atrial fibrillation onset and treatmentpatient reported

This systematic review highlights that dizziness and vertigo are frequent yet underrecognized manifestations in patients with atrial fibrillation that often improve with restoration of sinus rhythm, warranting their inclusion in routine clinical assessments and symptom evaluation tools.

Limitations

Current literature is sparse, fragmented, and largely descriptive, consisting of only five studies and several case reports
Exclusion of non-English articles without available translation
Systematic review protocol was not registered in a public registry
Systematic omission of vertigo and dizziness from standard AF symptom evaluation tools (e.g., AFSymp)
Small number of dedicated articles on this niche topic
Current literature remains sparse, fragmented, and largely descriptive, limited to several case reports without detailed clinical characteristics or diagnostic criteria
Articles published in languages other than English were excluded from the data extraction process
The protocol of the systematic review was not recorded in a public registry

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Implication

Supports screening for dizziness/vertigo in AF patients; extends evidence linking symptoms to arrhythmia and rhythm restoration.

Abstract

Background: Vertigo and dizziness have been observed in patients with atrial fibrillation (AF), yet their role as possible early manifestations of AF remains insufficiently understood. Methods: A systematic review of five relevant studies, comprising a total of 2102 patients, was conducted to evaluate the relationship between vestibular symptoms and AF. Results: Dizziness and vertigo were frequently reported, particularly in acute presentations, although they were rarely considered primary symptoms. Evidence suggests a potential correlation between vestibular manifestations and AF, with vertigo possibly acting as an autonomic or inflammatory trigger in selected cases. Conclusions: The findings highlight the clinical relevance of including vertigo and dizziness in the routine assessment of patients with AF. Proper recognition of these symptoms may reduce underdiagnosis, improve treatment adherence, and prevent complications associated with misattribution of vertigo to non-cardiac causes.

Discussion

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Cite This Study

Urs et al. (2025) conducted a systematic review in Atrial fibrillation (n=2,102). Vertigo and dizziness in atrial fibrillation was evaluated on Symptom improvement of dizziness and vertigo with restoration of sinus rhythm. Dizziness and vertigo were reported in up to 41.2% of atrial fibrillation patients, improving with sinus rhythm restoration in 60.7% of cases or vestibular treatment in 27.2%.

synapsesocial.com/papers/6a5c73d5761fee6e4b030fc6 https://doi.org/10.3390/jcm14197101

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A Relationship Between Atrial Fibrillation and Dizziness

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

A Relationship Between Atrial Fibrillation and Dizziness

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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