Atrial Fibrillation (AFib): Symptoms, Causes, Diagnosis and Treatment

What Is Atrial Fibrillation?

Atrial fibrillation (AFib) is the most common type of irregular heart rhythm (arrhythmia). It occurs when the upper chambers of the heart beat irregularly and out of sync with the lower chambers, reducing the heart’s ability to pump blood efficiently. Early diagnosis and treatment can help reduce the risk of complications such as ischaemic stroke and heart failure.

Quick Facts About Atrial Fibrillation 

• AFib is the most common sustained heart rhythm disorder.

• It causes an irregular and often rapid heartbeat.

• Some people have no symptoms.

• Untreated AFib increases the risk of stroke.

• Many people can successfully manage AFib with medication or procedures.

What Are the Symptoms of Atrial Fibrillation? 

Symptoms vary from person to person. Some people experience noticeable symptoms, while others are only diagnosed during a routine health check.

Common Symptoms

• Irregular and rapid heartbeat (palpitations)

• Shortness of breath

• Weakness or fatigue

• Dizziness or light-headedness

• Chest pain or discomfort

• Reduced ability to exercise

• Confusion

• Sweating

• Fainting or near-fainting episodes

Can Atrial Fibrillation Have No Symptoms?

Yes, some people have “silent AF”, where the condition causes no noticeable symptoms but still increases the risk of stroke.

Is Atrial Fibrillation Dangerous?

Although atrial fibrillation is not always life-threatening, it increases the risk of several serious complications if left untreated.

What Causes Atrial Fibrillation?

Heart-related conditions 

The following conditions increase the risk:

• Coronary artery disease

• Ischaemic heart disease

• Heart valve disease

• Heart failure

• History of heart attack

• High blood pressure (hypertension)

Other Risk Factors 

• Age: The risk increases as you get older.

• Chronic conditions: Diabetes, asthma, chronic kidney disease, and chronic lung disease.

• Obesity: Being overweight increases the risk.

• Thyroid disease: Hyperthyroidism and hypothyroidism.

• Smoking: Smoking is a significant risk factor.

• Excessive alcohol consumption: Drinking too much alcohol can trigger episodes of AFib.

• Sleep apnoea: Linked to a higher risk of AFib.

• Stress: Stress, along with other conditions like kidney disease, can contribute to the risk.

• Family history: This risk factor can increase the likelihood of AFib.

• Previous surgeries: Having had heart surgery increases the risk.

Diagnosis of Atrial Fibrillation

Diagnosing atrial fibrillation presents challenges as the episodes can be sporadic or persistent. It typically involves a combination of these tests and procedures to accurately identify the condition and determine the most appropriate treatment plan.

●     Electrocardiogram (ECG or EKG): Measures the electrical activity of your heart and can detect abnormal heart rhythms, including atrial fibrillation

●     Holter Monitor: A portable ECG device worn for 24 to 48 hours or longer to record your heart's electrical activity continuously, providing more information about irregular heart rhythms that may not be captured during a standard ECG

●     Event Recorder: Similar to a Holter monitor, but used for longer periods (weeks to months), activated by the patient when symptoms occur to capture irregular heart rhythms

●     Echocardiogram: This ultrasound test uses sound waves to create images of your heart, allowing doctors to assess its structure and function and identify any underlying heart conditions that may contribute to atrial fibrillation

●     Blood Tests: To check for underlying conditions, such as thyroid problems or electrolyte imbalances, which can contribute to atrial fibrillation

●     Stress Test: Evaluates how your heart responds to stress, usually through exercise, to detect irregular heart rhythms that may occur during physical activity

●     Electrophysiology Study (EPS): Invasive procedure involving the insertion of catheters into the heart to map its electrical signals and identify the source of abnormal heart rhythms, often used to guide treatment decisions in complex cases

●     Imaging Tests: MRI or CT scans may be performed to assess the structure of the heart and detect any abnormalities that may contribute to atrial fibrillation

●     Additional Monitoring: In some cases, long-term monitoring with implantable devices, such as loop recorders or implantable cardiac monitors, may be needed to capture infrequent episodes of atrial fibrillation

Management and Treatments of Atrial Fibrillation

●     Medications

• Medication for rate control: Beta-blockers and calcium channel blockers are prescribed to help lower the heart rate
• Medication for rhythm control: Antiarrhythmics work to preserve and repair a healthy heart rhythm
• Anticoagulants or blood thinners: These drugs help to lower the risk of blood clots and stroke risk

●     Cardioversion

• Electrical cardioversion: This technique shocks the heart with electricity to get it back to its regular rhythm
• Chemical cardioversion: Atrial fibrillation is brought back to a normal heart rhythm with medication
• Catheter Ablation: This minimally invasive technique destroys the heart tissue causing aberrant electrical signals by using radiofrequency or cryotherapy

●     Surgery

• Maze procedure: A surgical procedure to disrupt aberrant electrical pathways in the heart by forming scar tissue
• Atrioventricular node ablation and pacemaker implantation: This procedure may be suggested to regulate heart rate when other treatments are not working

●     Lifestyle Modifications

• Controlling underlying diseases like diabetes and hypertension
• Consuming a diet low in saturated fats and sodium that is heart-healthy
• Keeping a healthy weight and exercising on a regular basis
• Reducing alcohol intake and staying away from tobacco products

When Should You See a Doctor? 

Seek medical attention if you experience:

• New irregular heartbeat

• Persistent palpitations

• Chest pain

• Shortness of breath

• Fainting

• Sudden weakness or stroke symptoms

When to See a Cardiologist at Prince Court Medical Centre

Treatment of atrial fibrillation often requires close collaboration between cardiologists and cardiac electrophysiologists. A cardiologist treats the patient's blood vessel obstruction problem; a cardiac electrophysiologist treats your atrial fibrillation by processing the electrophysiological signals of the heart veins. 

As one of the authoritative hospitals for the best cardiologist and heart surgery in Malaysia, Prince Court Medical Centre has a professional and experienced team of cardiac specialists and cardiac electrophysiology specialists, equipped with advanced instruments, equipment and medicines to provide you with comprehensive heart health services.

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