Objectives. To examine the role of the presence of symptoms on illness representations. To examine the success of the Self-Regulation Model in explaining psychosocial adjustment in patients with atrial fibrillation (AF). Design. A cross-sectional study of 62 AF patients attending either specialized AF or cardiac out-patient clinics. Method. Individuals were classified as symptomatic or asymptomatic and completed the Illness Perception Questionnaire (IPQ), COPE, and Psychosocial Adjustment to Illness Scale (PAIS). Comparisons between groups and explanation of psychosocial adjustment were examined. Results. Symptomatic and asymptomatic participants did not differ on subscales of the IPQ, with the exception of identity. Both symptom status and IPQ subscales explained independent and significant amounts of variance in PAIS domains. In contrast the COPE accounted for minimal amounts of variance in all PAIS domains. Conclusions. The presence of symptoms is not directly influential in the elaboration of the illness representation. Both symptoms and illness representations should be targeted in interventions to improve adjustment to AF.