Feeling a fast or irregular heartbeat? It could be atrial fibrillation.
Atrial fibrillation (AF) is a common heart rhythm condition where the heart beats irregularly and often too fast. It can increase the risk of stroke if not recognised and treated early.
What is atrial fibrillation?
AF occurs when the upper chambers of the heart (atria) beat chaotically and out of sync with the lower chambers.
This can lead to:
- Irregular heartbeat
- Reduced efficiency of blood flow causing low blood pressure and near fainting or fainting attacks
- Formation of blood clots in the heart
These clots can travel to the brain and cause a stroke
Important facts
- Some people do not feel any symptoms at all
- AF is sometimes first diagnosed when a patient presents with a stroke
- AF can occur in episodes (called paroxysmal AF) or be continuous
The risk of stroke is similar, whether AF is occasional or persistent
Symptoms of atrial fibrillation
- Fast or irregular heartbeat (palpitations)
- Shortness of breath
- Dizziness or lightheadedness
- Fatigue which is more pronounced on any exertion
- Chest discomfort
Some patients have no symptoms and AF is found incidentally
How is AF diagnosed?
The gold standard test is an ECG (electrocardiogram)
This records the electrical activity of the heart
At home:
- Blood pressure machines may show an error or irregular reading
- This can happen because the heart rhythm is too irregular to measure accurately
Why is treating AF important?
AF increases the risk of:
- Stroke
- Heart failure
- Ongoing heart rhythm problems
Stroke is the most serious complication
Treatment options
Treatment depends on symptoms, timing, and stroke risk.
1. Heart rate control
Medications to slow the heart, such as:
- Beta-blockers (e.g. metoprolol)
- Other rate-controlling medications
2. Rhythm control
- Medications or procedures to restore normal rhythm
- If AF is diagnosed within 48 hours, there may be an option to reset the heart rhythm using a short procedure (cardioversion)
This is usually done in hospital under specialist care
3. Blood thinners (VERY IMPORTANT)
- Reduce the risk of stroke
- Prescribed based on individual risk
Doctors use a scoring system called CHA₂DS₂-VASc which considers:
- Age
- Blood pressure
- Diabetes
- Heart failure
- Previous stroke
- Other risk factors
The higher the score, the higher the stroke risk
Important:
Aspirin is not effective for preventing stroke in AF
Stronger blood thinners are usually required, such as:
- Apixaban (Eliquis)
- Rivaroxaban (Xarelto)
When to seek urgent care
Seek immediate medical attention if you have:
- First episode of palpitations or irregular heartbeat
- Chest pain
- Severe shortness of breath
- Fainting or near fainting
- A rapid heart rate that is not settling
Why early assessment matters
If AF is diagnosed within the first 48 hours:
- There may be an option to restore normal rhythm
- After this period, the risk of stroke increases, and management becomes more complex
How VEMSA can help
We can:
- Assess your symptoms via video consultation
- Guide immediate management
- Review your heart rate and symptoms
- Arrange urgent referral to hospital or a cardiologist if needed
- Coordinate follow-up and ongoing care
Key takeaway
- AF is common and treatable, although it tends to recur
- Some patients remain in AF long-term with medical management
- The main risk is stroke
- Early assessment and appropriate treatment are essential
Need help now?
- Seen within minutes
- Available 24/7, 365 days/year
- No booking required
- No out-of-pocket cost
Start your consultation with an emergency-trained clinician now
Evidence and references
This information is based on established clinical guidelines and major studies:
- Heart Foundation Australia
- European Society of Cardiology
- American Heart Association
Key evidence (simplified):
- AF increases stroke risk by about 4–5 times compared to people without AF
- Blood thinners reduce stroke risk by around 60–70%
- Up to 1 in 3 patients with AF may have no symptoms
- Stroke can be the first presentation of AF in some patients
Disclaimer
This information is for general education only and does not replace individual medical advice. If you are concerned or have severe symptoms, seek urgent medical care.