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Ziva Health › Conditions › Atrial Fibrillation (AFib)

Your heart's rhythm
tells a story.
Ziva reads it daily.

AFib episodes are unpredictable and often silent between appointments. Ziva's AI coach Isabella monitors your heart rate irregularity, HRV, sleep, activity, and triggers every day - so you and your cardiologist always have the full picture, not just a snapshot.

Used by people managing AFib alongside their care team.

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🔒 HIPAA compliant ⌚ Apple Watch, Garmin & more ✦ Free to start
Isabella, Ziva's AI coach · Heart rhythm brief
Heart rhythm trace today · irregular segments flagged
Episodes today
2
↑ irregular rhythm
Longest episode
14 min
at 2:18 AM
7-day burden
8.4%
↑ vs last week
Isabella · Pattern found
"Both episodes this week followed nights with alcohol logged within 3 hours of bed. Last night: 2 glasses of wine at 9pm, episode at 2:18 AM. This is the 4th time this correlation has appeared. Your cardiologist should see this pattern."
New to Ziva?

Ziva Health is an AI-powered health companion for managing conditions like AFib through daily tracking and personalised coaching. Isabella is Ziva's AI health coach - she reads your heart rhythm data, HRV, sleep, and activity every day and tells you what's happening and what's driving your episodes.

How Ziva works

Three steps to understanding your AFib.

⌚
01
Wear your device all day
Ziva pulls heart rate, rhythm data, HRV, and activity from Apple Watch, Garmin, Fitbit, or Samsung automatically - all day, every day.
🧠
02
Isabella finds the triggers
She cross-references episode timing with alcohol, sleep, stress, caffeine, exercise, and medication logs - finding your personal pattern over time.
📋
03
Share with your cardiologist
Isabella generates a 30-day AFib burden report - episode count, duration, burden %, triggers, and HRV trend - ready for your next appointment.
Start tracking for free →
What Ziva tracks

Every signal AFib leaves
in your daily data.

AFib episodes leave measurable traces across heart rhythm, HRV, sleep, and recovery. Ziva captures all of these automatically from your wearable every day - and Isabella connects them into a picture your cardiologist can act on.

What Isabella tracks for AFib
Daily · automatic
❤️ Heart rate irregularity & AFib detection
Continuous heart rate monitoring from your wearable. Isabella flags irregular rhythm episodes, tracks episode count, duration, and 7-day AFib burden percentage.
💓 HRV in sinus rhythm
HRV measured during confirmed normal rhythm periods - a key predictor of AFib recurrence risk and cardiovascular recovery. Isabella tracks your trend vs baseline.
😴 Sleep quality & nocturnal episodes
AFib episodes frequently occur during sleep. Isabella cross-references sleep stages and fragmentation with episode timing - nocturnal AFib is often missed without continuous monitoring.
🍷 Trigger logging & correlation
Alcohol, caffeine, stress, sleep deprivation, and illness - all logged and correlated with same-day and next-day episode occurrence. Isabella finds your personal triggers.
💊 Medication adherence
Anticoagulants and rate/rhythm control medications tracked daily. Isabella flags missed doses and correlates adherence gaps with increased episode frequency.
🏃 Activity & exercise response
Exercise intensity and timing correlated with episode occurrence. Some people trigger AFib with high-intensity exercise - Isabella helps you find your safe exercise zone.
1 in 4
Adults over 40 will develop AFib in their lifetime
5×
Higher stroke risk with untreated AFib
30%
Of AFib cases are paroxysmal - episodes missed between appointments
70%
Of episodes have identifiable lifestyle triggers
How Ziva helps

AFib isn't one event.
It's a pattern - visible in your data.

Paroxysmal AFib comes and goes - often silently. Between appointments, episodes occur, triggers stack up, and medication adherence slips. Ziva captures all of it. Isabella connects the dots so you and your cardiologist have the full picture, not just the snapshot from your last visit.

❤️AFib episode detection & burden tracking
💓HRV in sinus rhythm — recurrence predictor
😴Nocturnal episodes & sleep quality
🍷Trigger logging & correlation
💊Anticoagulant & medication adherence
Isabella · AFib burden & triggers — last 7 days
Alcohol within 3h bed
High
Poor sleep nights
Mod
High-stress days
Mod
Medication adherence
Good
Zone 2 exercise
+OK
Isabella · 7-day pattern
"You had 4 AFib episodes this week — all within 4 hours of alcohol consumption. On the 3 nights you didn't drink, you had zero episodes. Alcohol is your most consistent trigger by far. Your cardiologist needs to see this data before your next visit."
AFib Episode Detection

Episodes your doctor
would never otherwise see.

Paroxysmal AFib episodes last minutes to hours and often occur at night or at rest - long after your wearable data is collected. Isabella reads your rhythm data every day and flags every episode: when it started, how long it lasted, and what was happening beforehand.

✓ Episode count, duration, and timing logged automatically every day
✓ 7-day AFib burden % — the metric your cardiologist uses to assess control
✓ 30-day trend — is your AFib burden worsening, improving, or stable?
✓ Nocturnal vs daytime episode breakdown — timing matters for treatment decisions
Apple Watch is FDA-cleared for AFib detection. Ziva reads and contextualises this data daily - giving your cardiologist continuous rhythm intelligence, not just a single ECG snapshot.
Isabella · AFib burden — last 7 nights
AFib episodes — last 7 days
M
T
W
T
F
Sa
Su
4 episodes this week 3/4 after alcohol
Isabella · Burden alert
"Your 7-day AFib burden is 8.4% — up from 3.1% last week. The three longest episodes all followed alcohol consumption within 3 hours of bedtime. Tuesday and Friday were alcohol-free and episode-free."
7-day burden
8.4%
↑ from 3.1% last week
Longest episode
47 min
Thursday, 1:42 AM
HRV in sinus rhythm — 30-day trend
30 days agoToday
HRV now
42ms
30 days ago
31ms
Trend
↑ 35%
Isabella · HRV insight
"Your HRV in sinus rhythm has improved 35% since you cut alcohol — from 31ms to 42ms. Higher HRV predicts lower AFib recurrence risk. This is the most important number on your report for your cardiologist."
HRV & Trigger Tracking

Your HRV predicts
your next episode - days ahead.

Low HRV in sinus rhythm is one of the strongest predictors of AFib recurrence. Ziva tracks your HRV daily during normal rhythm periods and builds a personal baseline - so Isabella can flag when you're entering a high-risk window before an episode occurs.

✓ HRV trend vs your personal baseline — not a population average
✓ Trigger correlation — alcohol, caffeine, stress, poor sleep flagged against episode timing
✓ Low-HRV warning — Isabella alerts you when your recovery score signals elevated risk
✓ Post-cardioversion or ablation HRV recovery tracking
42ms
HRV in sinus rhythm
↑ 35% in 30 days
4
Episodes this week
↑ vs 1 last week
75%
Episodes after alcohol
↑ strongest trigger
Medication & Lifestyle

Your anticoagulant
only works when you take it.

Missing anticoagulant doses - even one - significantly increases stroke risk in people with AFib. Ziva tracks your medications daily alongside your episode data, so your cardiologist can see whether gaps in adherence correlate with increased AFib burden.

✓ Anticoagulant adherence (warfarin, apixaban, rivaroxaban) logged daily
✓ Rate and rhythm control medications — beta blockers, flecainide, amiodarone tracked
✓ Lifestyle modifications tracked — alcohol reduction, weight, salt, exercise type
✓ Post-ablation or cardioversion recovery monitoring
Isabella · Medication & lifestyle — this month
Apixaban (2× daily)
94%
Metoprolol (daily)
98%
Alcohol-free days
18/30
Exercise (Zone 2)
108m
Isabella · Medication insight
"Medication adherence is strong — 94% and 98%. The variable is lifestyle. On the 12 days you drank alcohol, 4 AFib episodes occurred. On the 18 alcohol-free days, 0 episodes. The intervention that will most reduce your burden isn't a medication change — it's this pattern."
Daily routine

Isabella builds your AFib
management routine around your triggers.

Not a generic checklist - a daily routine shaped by what your data shows is actually triggering your episodes: when to exercise, what to avoid, how to manage stress, and how to take your medications consistently.

Your AFib routine — built by Isabella
AFib focus
7:30 AM
💊
Morning medication
Apixaban + Metoprolol. Isabella logs it and tracks your 30-day adherence rate for your cardiologist report.
8:00 AM
📊
Review last night's rhythm data
Isabella shows any overnight episodes, HRV vs baseline, and flags if anything needs cardiologist attention.
10:00 AM
🚶
Zone 2 walk — 30 min
Your data shows Zone 2 exercise doesn't trigger episodes. Morning timing avoids the evening window where your risk is highest.
7:30 PM
🍷
Alcohol cutoff
75% of your episodes follow alcohol within 3h of bed. Cutoff at 7:30pm means 3h+ gap before your typical sleep time.
9:00 PM
🌬️
Evening wind-down breathing
Box breathing or 4-7-8 for 5 minutes. Activates parasympathetic nervous system, reducing the sympathetic triggers that initiate AFib.
10:00 PM
😴
Sleep — target 7.5h consistent
Sleep deprivation is your second biggest trigger after alcohol. Consistent bedtime helps maintain sinus rhythm overnight.
Adapts as your burden changes.
As your AFib burden improves, Isabella adjusts your routine - reinforcing what's working and changing what isn't. After cardioversion or ablation, she shifts to recovery monitoring mode.
Lifestyle impact — evidence summary
Alcohol elimination −37% recurrence
Weight loss (≥10%) −50% burden
Regular moderate exercise −28% episodes
Sleep improvement −20% recurrence
Combined lifestyle Substantial reduction
Based on published clinical research. Individual results vary.
The evidence

What the science says.

Every Ziva feature for AFib is grounded in peer-reviewed evidence - Isabella explains the mechanism, not just the metric.

5×
Higher stroke risk
Untreated or poorly controlled AFib raises stroke risk fivefold - through clots forming in the fibrillating left atrial appendage. Continuous monitoring ensures anticoagulant adherence is documented and AFib burden trends are visible before they become dangerous.
−37%
AFib recurrence with alcohol abstinence
The HOLIDAY HEART study and subsequent research confirm alcohol as the most potent modifiable AFib trigger. Even moderate drinking significantly increases burden. Ziva correlates alcohol logs with episode data to show you - and your cardiologist - the causal relationship in your own numbers.
−50%
AFib burden with 10% weight loss
The LEGACY trial showed that sustained 10% weight loss reduced AFib burden by 50% - a larger effect than most antiarrhythmic drugs. Ziva tracks weight, activity, and nutrition alongside AFib burden so you can see this relationship in your own data as it unfolds.
Work with your cardiologist

Your cardiologist needs
30 days of data,
not one ECG.

AFib is managed on trends and burden - not snapshots. Ziva gives your cardiologist 30 days of episode data, HRV, medication adherence, and trigger correlation in a clear report they can review in minutes.

Provider not on Ziva yet?
Send your cardiologist a link. When they join Ziva, they see your AFib burden, HRV trend, and medication adherence directly - and can act between appointments.
Refer Ziva to my cardiologist
Already seeing your cardiologist?
Bring your Ziva 30-day report - AFib burden %, episode log, HRV trend, medication adherence, and trigger analysis. Most cardiologists find this immediately actionable for treatment decisions.
Bring my data to my appointment →
Ziva Provider Report
30-day AFib summary · Generated by Isabella
PDF ready
30-day AFib burden
6.2%
↑ vs 2.1% prior period
Total episodes · 30 days
11
avg 22 min duration
HRV in sinus rhythm 42ms ↑ 35% improvement
Apixaban adherence 94% ✓ Good
Alcohol-free days 18/30 ↑ main trigger
Episodes post-alcohol 8/11 episodes (73%)
Isabella · Summary for cardiologist
"AFib burden increased to 6.2% this period. Primary driver: 73% of episodes correlate with alcohol within 3 hours of sleep onset. Medication adherence is strong. Recommend discussing alcohol cessation as primary intervention before considering antiarrhythmic escalation."
Understanding the condition

What is atrial fibrillation?

Atrial fibrillation (AFib or AF) is the most common serious cardiac arrhythmia, affecting over 37 million people worldwide. It occurs when the heart's upper chambers (atria) beat chaotically and out of coordination with the lower chambers (ventricles), producing an irregular and often rapid heart rhythm. This electrical chaos prevents effective atrial contraction, allowing blood to pool - particularly in the left atrial appendage - creating clots that can travel to the brain and cause stroke.

Types of AFib

Type
Duration
Clinical significance
Paroxysmal
Terminates in <7 days
Most commonly missed
Persistent
Lasts >7 days
Cardioversion usually needed
Long-standing
Continuous >12 months
Ablation or rate control
Permanent
Ongoing, accepted
Rate control + anticoagulation

Signs and symptoms

  • →Palpitations — fluttering, racing, or irregular heartbeat sensation; often the first noticeable symptom
  • →Fatigue — the inefficient atrial contraction reduces cardiac output by 10–30%, causing significant tiredness
  • →Shortness of breath — especially during activity or when lying flat; a sign of reduced cardiac efficiency
  • →Dizziness or lightheadedness — particularly at episode onset when rhythm suddenly changes
  • →Chest discomfort — pressure or tightness during AFib episodes; always investigate with a cardiologist
  • →No symptoms — up to 30% of AFib episodes are completely silent; detected only by continuous monitoring or incidental ECG

Risk factors and triggers

  • →Alcohol — the most potent modifiable trigger; even moderate drinking (1–2 drinks/day) significantly increases burden
  • →Hypertension — the leading structural risk factor; elevates atrial pressure and promotes electrical remodelling
  • →Obesity — adipose tissue around the heart promotes inflammation and structural remodelling of the atria
  • →Sleep apnea — nocturnal oxygen drops trigger sympathetic surges that initiate AFib; treating OSA reduces burden significantly
  • →Stress and poor sleep — cortisol and adrenaline disrupt the autonomic tone balance that maintains sinus rhythm
  • →Excessive endurance exercise — "athlete's heart" and years of high-intensity training structurally enlarge the atria, increasing lifetime risk

Consequences of uncontrolled AFib

  • →Stroke — 5× higher risk; AFib-related strokes are more severe and more likely fatal than non-AFib strokes
  • →Heart failure — sustained rapid ventricular rates from AFib cause tachycardia-induced cardiomyopathy over time
  • →Progression to permanent AFib — paroxysmal AFib remodels the atria electrically and structurally; without intervention, it typically progresses
  • →Dementia — growing evidence links AFib to vascular cognitive impairment through subclinical microemboli and reduced cerebral blood flow
How Ziva helps you stay ahead of progression
Ziva's 30-day burden tracking, trigger correlation, and medication adherence data give your cardiologist the continuous intelligence needed to catch burden increases early - before paroxysmal AFib becomes persistent. It doesn't replace clinical management; it makes clinical management far more informed.
⚠ When to seek urgent care
If you experience sudden chest pain, severe shortness of breath, fainting, or one-sided weakness or face drooping alongside an irregular heartbeat - call 999/911 immediately. These may be signs of stroke or acute cardiac decompensation.
Start tracking with Ziva
Isabella reads your heart rhythm every day and gives your cardiologist 30-day trend data they can actually act on.
Download the app →
Common questions

What people ask.

Ziva Health is a wellness and health-coaching app. It is not a medical device and does not diagnose AFib or any other cardiac condition. All content is for informational purposes only. Always consult a qualified cardiologist or healthcare professional for medical decisions about AFib management. Never stop or adjust cardiac medications without clinical supervision.

Isabella AI

Stop guessing
what's triggering
your episodes.

Isabella reads your heart rhythm every day and gives your cardiologist 30 days of AFib burden, HRV trend, medication adherence, and trigger data - so appointments are actually informed.

Free to start · No credit card · HIPAA compliant

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