A racing, fluttering or irregular heartbeat, unexplained fatigue, breathlessness or declining exercise capacity may sometimes signal Atrial Fibrillation (AFib), an abnormal heart rhythm that can increase the risk of serious cardiovascular complications.

Highlighting the need for greater awareness, Prof. Dhiraj Gupta, cardiac electrophysiologist from Liverpool, UK, and Dr. C. Narasimhan, Director & HOD, Electrophysiology Services, AIG Hospitals, recently discussed AFib, its potential consequences and the importance of early diagnosis.

AFib occurs when the electrical activity in the heart's upper chambers becomes disorganised, resulting in an irregular heartbeat. While some patients experience palpitations, dizziness or breathlessness, others may have few or no noticeable symptoms, with the condition sometimes detected during routine examinations or evaluations for unrelated health concerns.

A major concern associated with AFib is stroke. The irregular contraction of the upper chambers can allow blood to pool and form clots. If a clot travels to the brain, it can result in a stroke. Early identification of AFib therefore allows doctors to assess an individual's stroke risk and consider preventive treatment where appropriate.

Modern AFib management takes a comprehensive approach. The 2024 European Society of Cardiology (ESC) guidelines recommend an AF-CARE framework covering management of comorbidities and risk factors, prevention of stroke and thromboembolism, rate and rhythm control, and ongoing reassessment.

Experts also highlighted that AFib does not necessarily cause dramatic symptoms. Recurrent palpitations, an irregular pulse, breathlessness, dizziness or unexplained reduction in exercise tolerance warrant medical evaluation, particularly among people with cardiovascular risk factors.

While smartwatches and wearable devices are increasingly capable of detecting potential rhythm irregularities, experts cautioned that device alerts should be treated as a prompt for medical evaluation rather than a definitive diagnosis. 

 ECGs and longer-duration rhythm monitoring remain important tools for confirming AFib.