Have you ever noticed your heart suddenly racing after climbing a flight of stairs or getting some unexpected news?
That’s perfectly normal. Our heart speeds up and slows down throughout the day depending on what we’re doing.
But what if your heart wasn’t just beating faster? What if it was beating irregularly, almost as if it couldn’t make up its mind what rhythm to follow?
For some people, that’s exactly what happens.
It’s called atrial fibrillation, or AF for short, and it’s the most common heart rhythm disorder in the world. Millions of people live with it, and many don’t even know they have it.
That last part is perhaps the most surprising.
As a pharmacist, I’ve spoken to people who discovered they had AF during a routine blood pressure check, before an operation, or even after buying a home blood pressure monitor that flashed up an irregular heartbeat symbol. They felt absolutely fine. Others described feeling as though there was a fish flapping around inside their chest.
The experience can be very different from one person to another.
So what exactly is atrial fibrillation?
A healthy heart has its own natural electrical system.
Think of it as an orchestra with a conductor. Every beat is carefully timed so the upper chambers of the heart contract first, followed by the lower chambers. The result is a smooth, regular heartbeat that efficiently pumps blood around the body.
In atrial fibrillation, that conductor loses control.
Instead of one organised electrical signal, hundreds of tiny electrical impulses fire chaotically through the upper chambers, known as the atria. Rather than squeezing properly, they quiver or fibrillate.
The lower chambers still pump blood, but they receive these mixed-up signals in an irregular pattern. The heartbeat may become fast, slow or simply unpredictable.
Instead of a steady “lub-dub, lub-dub,” the rhythm becomes irregular.
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What does AF feel like?
For some people, nothing at all.
That is one of the biggest challenges with atrial fibrillation.
Others notice their heart pounding, fluttering or racing. Some feel breathless when walking short distances. Others become tired more easily than usual, feel light-headed or notice reduced exercise tolerance.
Occasionally people describe a feeling of anxiety because they can sense their heart behaving differently.
Symptoms may come and go. Some people have episodes lasting a few minutes, while others remain in atrial fibrillation continuously.
The important point is this: the severity of symptoms does not always reflect how serious the condition is.
Someone who feels perfectly well may still have a significant risk of complications.
Why does it matter?
The biggest concern isn’t the irregular heartbeat itself.
It’s what can happen because of it.
When the upper chambers of the heart stop squeezing effectively, blood can pool inside them. Blood that sits still is more likely to form a clot.
If part of that clot breaks away, it can travel through the bloodstream into the brain and block an artery, causing a stroke.
This is why untreated atrial fibrillation significantly increases the risk of stroke.
The good news is that for many people, this risk can be greatly reduced with the right treatment.
Who is more likely to develop AF?
Anyone can develop atrial fibrillation, but it becomes more common as we get older.
High blood pressure is one of the biggest risk factors.
Heart disease, diabetes, obesity, sleep apnoea and an overactive thyroid can also increase the likelihood of developing AF.
Heavy alcohol intake, particularly binge drinking, can trigger episodes in some people. In fact, doctors sometimes refer to this as “holiday heart syndrome” because it has been recognised after weekends or holidays involving excessive drinking.
Occasionally, AF develops without any obvious cause.
How is it diagnosed?
Sometimes a healthcare professional notices an irregular pulse during a routine examination.
An electrocardiogram, or ECG, confirms the diagnosis by recording the heart’s electrical activity.
Increasingly, smart watches and fitness trackers are also alerting people to possible irregular heart rhythms.
These devices can be useful, but they are not perfect. They can occasionally produce false alarms or miss episodes altogether.
If your device repeatedly warns of an irregular rhythm, don’t ignore it, but don’t panic either. Arrange an appointment with your doctor so proper tests can be carried out.
Can you check your own pulse?
Yes, and it’s a useful habit.
Place two fingers gently on the thumb side of your wrist, just below the base of the thumb.
Count the beats for 30 seconds.
A normal pulse usually feels steady, like the ticking of a clock.
With atrial fibrillation, the rhythm often feels completely irregular. There may be no obvious pattern at all.
Checking your pulse occasionally isn’t about trying to diagnose yourself. It’s simply another way of becoming familiar with your own body.
How is AF treated?
Treatment depends on the individual.
Some people need medicines to slow the heart rate. Others may be offered medicines or procedures to restore a normal rhythm.
Many people also require anticoagulants, often called blood thinners, although they don’t actually make the blood thinner. Instead, they reduce its ability to form dangerous clots, dramatically lowering the risk of stroke.
Doctors carefully assess each person’s individual stroke risk before deciding whether these medicines are needed.
For some patients, a procedure called catheter ablation may be recommended. Using thin tubes passed through blood vessels, specialists can destroy the tiny areas of heart tissue responsible for triggering the abnormal electrical signals.
Treatment has advanced enormously over the past two decades, and many people with atrial fibrillation continue to lead full, active lives.
Can lifestyle make a difference?
Absolutely.
Keeping blood pressure under control is one of the best ways to reduce the risk of AF.
Maintaining a healthy weight, exercising regularly, limiting alcohol, stopping smoking and treating conditions such as sleep apnoea can all help.
Even for people already diagnosed with AF, lifestyle changes often improve symptoms and reduce future problems.
A final thought
One thing that fascinates me about atrial fibrillation is how something so important can be so easy to miss.
You can have an irregular heartbeat for months, or even years, and feel completely normal.
That’s why routine health checks matter. Sometimes the most valuable discoveries are made before you ever notice a symptom.
Your heart spends every minute of your life keeping you alive without asking for thanks.
The least we can do is pay attention when it starts beating to a different rhythm.
Until next time, stay curious, stay informed and, above all, look after your health. It is one investment that will always pay dividends.
The Daily Durian (zaynp100@yahoo.com) is a content creator under the Newswav Creator programme, where you get to express yourself, be a citizen journalist, and at the same time monetize your content & reach millions of users on Newswav. Log in to creator.newswav.com and become a Newswav Creator now!
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