Atrial fibrillation: what it means and who manages it
Atrial fibrillation is a common irregular heart rhythm. Here's what it is, why stroke prevention matters and when to see a cardiologist.
Atrial fibrillation, often called AF, is the most common type of irregular heart rhythm. In AF, the upper chambers of the heart beat in a fast, chaotic way instead of a steady rhythm. It becomes more common with age, and is linked with high blood pressure, heart disease, sleep apnoea, heavy alcohol use and being overweight.
Some people feel nothing. Others notice:
- A fluttering, racing or irregular heartbeat
- Tiredness or less energy for exercise
- Shortness of breath
- Dizziness or feeling faint
- Chest discomfort
AF can come and go, or be present all the time. It is often found on a routine pulse check or an ECG, or by a smartwatch alert.
Why AF matters
AF itself is not usually immediately dangerous, but it raises the risk of stroke. Blood can pool in the heart and form clots that travel to the brain. Many people with AF are offered a blood-thinning medicine to lower this risk. Your doctor will weigh your stroke risk against your bleeding risk. Never start or stop these medicines without medical advice.
Who you'll see
Your GP will check your pulse, do an ECG and arrange blood tests. They may refer you to Cardiology, especially if AF is new, causing symptoms, hard to control, or if you have other heart problems.
A cardiologist may arrange:
- An echocardiogram, an ultrasound of the heart
- A heart monitor worn for a day or longer
- Treatments to control the heart rate or bring it back to a normal rhythm
- A procedure called catheter ablation for some people, often done by a cardiologist who specialises in heart rhythm
Looking after your general health also helps. Treating blood pressure and sleep apnoea, cutting back on alcohol, being active and reaching a healthier weight can reduce AF episodes. Some people see Exercise physiology or Dietetics for support.
You need a GP referral to claim a Medicare rebate for a cardiologist. Fees and test costs vary, so ask first. Spec Book shows which cardiologists have the soonest appointments, and your GP can send the referral with the booking.
When to get urgent help
Call 000 straight away if you have chest pain, severe shortness of breath or fainting. Also call 000 for any signs of stroke. Think FAST:
- Face: has their face drooped?
- Arms: can they lift both arms?
- Speech: is their speech slurred or confused?
- Time: call 000 straight away, even if the symptoms go away
Common questions
Can AF go away on its own?
Some episodes stop by themselves, but AF often comes back or becomes more frequent over time. Ongoing review with your doctor is important.
Can I exercise with AF?
Most people with AF can and should stay active. Check with your doctor about what's right for you, especially if you have symptoms.
Does a smartwatch diagnose AF?
A watch alert can be a useful prompt, but the diagnosis is confirmed with an ECG. Show the reading to your GP.
Will I need a blood thinner?
Not everyone does. It depends on your stroke risk, which your doctor works out using factors such as age and other conditions.
General information only, not medical advice. Everyone's situation is different, so check with your GP or the provider. In an emergency call 000.