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Patent Pending Atrial fibrillation (AF or A-fib) is the most common abnormal heart rhythm. It may cause no symptoms, but is often associated with palpitations, fainting, chest pain, or congestive heart failure. The cause of an individual's AF may not be identified. AF may be identified clinically when taking a pulse, and its presence can be confirmed with an electrocardiogram (ECG) that demonstrates the absence of P waves and an irregular ventricular rate.