Atrial Fibrillation
An irregular, often rapid heart rate that causes poor blood flow and significantly increases the risk of stroke.
Atrial fibrillation (AFib) is the most common sustained cardiac arrhythmia, characterised by disorganised electrical activity in the atria causing an irregular and often rapid heart rate. The condition significantly elevates stroke risk and contributes to heart failure and cognitive decline.
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Atrial fibrillation disrupts the heart's normal electrical rhythm, leading to poor circulation and a dramatically increased risk of stroke.
Types of AFib
- Paroxysmal — resolves spontaneously within seven days
- Persistent — lasts longer than seven days, requiring intervention
- Long-standing Persistent — continuous for over 12 months
- Permanent — joint decision to focus on rate control rather than rhythm restoration
Symptoms
- Palpitations: fluttering, racing, or irregular heartbeats
- Breathlessness and fatigue
- Reduced exercise tolerance
- Dizziness and chest discomfort
- Many patients experience no symptoms — detected incidentally on ECG or during stroke investigation
Causes & Risk Factors
- Hypertension, coronary artery disease, valvular disease, heart failure
- Sleep apnoea
- Reversible causes: hyperthyroidism, kidney disease, alcohol overuse
- Age and family history
Stroke Prevention
The CHA₂DS₂-VASc score guides anticoagulation decisions. Direct oral anticoagulants (DOACs) are the preferred treatment. Left atrial appendage closure offers an alternative for those unable to tolerate anticoagulation.
Treatment Options
- Rate control: beta-blockers or calcium channel blockers
- Rhythm control: antiarrhythmic medications or pulmonary vein isolation ablation
- Catheter ablation shows superior outcomes for paroxysmal AFib
- Anticoagulation to reduce stroke risk
Concerned About Atrial Fibrillation?
Dr. Peter Chang offers specialist assessment and personalised management at Paragon Medical Centre, Singapore.