Atrial fibrillation is a type of arrhythmia, which means an abnormal heart rhythm. In a normal heartbeat, electrical signals help the upper and lower chambers of the heart work together.

In atrial fibrillation, the electrical signals in the upper chambers of the heart become ‘chaotic’. As a result, the upper chambers are unable to contract properly, and the heartbeat may become irregular, fast, and sometimes unstable.

Symptoms of Atrial Fibrillation

Atrial fibrillation can feel different from person to person. Some people have noticeable symptoms, while others have none.

Common symptoms may include:

  • Noticeably fast, fluttering or pounding heartbeat
  • Irregular heartbeats
  • Shortness of breath
  • Dizziness or lightheadedness
  • Tiredness or reduced stamina
  • Weakness or fatigue
  • Chest discomfort
  • Fainting spells

Some people may only notice symptoms during exercise, stress, or illness. Others may feel them even when resting.

What Causes Atrial Fibrillation?

Atrial fibrillation can happen when changes in the heart’s structure or electrical system affect its rhythm.

Possible factors and triggers include:

In some people, no clear cause is found for atrial fibrillation.

What Are the Types of Atrial Fibrillation?

Atrial fibrillation may happen with different patterns.

1. Paroxysmal Atrial Fibrillation

Symptoms come and go, with episodes lasting minutes, hours or days before the heart's rhythm may return to normal on its own.

2. Persistent Atrial Fibrillation

The heart rhythm does not return to normal by itself. Treatment may be needed to restore or control the heart rhythm.

3. Permanent Atrial Fibrillation

This means the heart’s irregular rhythm remains over the long term. Treatment usually focuses on controlling the heart rate and reducing the risk of stroke.

What Are the Possible Complications of Atrial Fibrillation?

Atrial fibrillation may increase the risk of:

  • Blood clots
  • Stroke
  • Heart failure
  • Worsening heart disease
  • Reduced exercise tolerance
  • Recurrent hospital visits if symptoms are not controlled

Stroke prevention is an important part of atrial fibrillation care. Not everyone with atrial fibrillation has the same stroke risk, so your doctor may assess your age, medical history, and other health conditions before recommending treatment.

How Is Atrial Fibrillation Diagnosed?

Atrial fibrillation is usually diagnosed with an electrocardiogram, also called an ECG. This test records the electrical activity of the heart and can show whether the rhythm is irregular.

Other tests may include:

  • Blood tests
  • An echocardiogram
  • A chest X-ray
  • Holter monitoring or ambulatory ECG monitoring
  • Blood pressure measurement
  • A thyroid function test
  • A kidney function test

These tests help your doctor check for possible causes, assess your heart health, and decide on the most suitable treatment plan.

Nowadays, certain wearable smart devices such as smartwatches or health rings can also detect episodes of atrial fibrillation, although confirmation with medical-grade devices is still required.

Can Atrial Fibrillation Be Prevented?

Atrial fibrillation cannot always be prevented, especially if it is related to age, heart disease, or other medical conditions.

However, you may lower your risk by:

  • Keeping blood pressure under control
  • Managing cholesterol and diabetes
  • Maintaining a healthy body weight
  • Not smoking
  • Limiting alcohol
  • Exercising regularly at a suitable intensity
  • Getting enough sleep
  • Treating sleep apnoea
  • Going for regular health checks if you have risk factors
ECG monitoring showing an irregular heart rhythm

When Should You See a Doctor?

You should see a doctor if you often experience heart palpitations, a fast or irregular heartbeat, breathlessness, dizziness, fainting, chest discomfort, unusual tiredness or a reduced ability to exercise.

Seek immediate medical attention at your nearest A&E Department if you have severe chest pain, severe breathlessness, fainting, or signs of a stroke such as facial drooping, arm weakness, difficulty speaking, or sudden confusion.

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Frequently Asked Question (FAQ)

Is atrial fibrillation dangerous?

Atrial fibrillation is not always immediately life threatening, but it can be serious. It may increase the risk of stroke, heart failure, and other heart related complications if not properly managed.

What does atrial fibrillation feel like?

Some people feel racing, fluttering, or pounding heartbeat. Others may feel breathless, dizzy, tired, or weak. Some people do not experience any symptoms.

Can atrial fibrillation happen without symptoms?

Yes. Some people have atrial fibrillation without knowing it. It may only be found during a pulse check, ECG, or routine health screening.

Can atrial fibrillation cause a stroke?

Yes. Atrial fibrillation can increase the risk of blood clots forming in the heart. If a clot travels to the brain, it may cause a stroke.

Can atrial fibrillation go away?

Some episodes of atrial fibrillation may come and go. In other cases, the condition may become persistent or permanent. Treatment can help control symptoms and lower risk of complications.

When should I seek urgent medical help?

You may first consult a general practitioner if you experience palpitations or an irregular heartbeat. You may then be referred to a cardiologist for further assessment.

At Nobel Heart Centre in Singapore, our cardiologists can assess and manage atrial fibrillation and other heart rhythm conditions.