Sometimes we may feel our heart pounding or racing off and on, and after multiple check-ups that show nothing abnormal, we may think, “It’s probably nothing serious.”
However, in reality, atrial fibrillation (AF) can occur at any time. In many cases, it happens intermittently—this is called Paroxysmal Atrial Fibrillation (PAF). Over time, PAF can progress and become Permanent Atrial Fibrillation, where the heart remains in an irregular rhythm and is no longer able to return to its normal rhythm.
This progression makes AF a silent but serious threat that requires early detection and proper management.
Why Is Atrial Fibrillation Dangerous?
This condition, often referred to by doctors in Thai as “fluttering heart,” is medically known as Atrial Fibrillation (AF). In AF, the upper chambers of the heart (atria) fire electrical impulses irregularly and unsynchronously, disrupting normal heart rhythm.
This abnormal rhythm leads to structural and hormonal changes within the heart, promotes inflammation in the heart and blood vessels, and increases the formation of blood clots—particularly in the heart and brain. As a result, AF is strongly associated with two serious conditions:
- Stroke (Ischemic Stroke) – with an annual incidence of up to 3%,
- Heart Failure, due to the heart’s impaired pumping ability.
But here’s the good news!
You can reduce the risk of complications by up to 10 times with timely diagnosis, early treatment, and choosing the right treatment strategy.
Causes of Atrial Fibrillation Include:
- Anxiety, chronic stress, or acute emotional stress
- High blood pressure
- Coronary artery disease or weakened heart muscle
- Heart valve disorders
- Hyperthyroidism
- Excessive consumption of alcohol or caffeine
- Inadequate sleep or rest
- Or it may occur without a clearly identifiable cause (Idiopathic)
Symptoms of Atrial Fibrillation
Some people with atrial fibrillation may have no noticeable symptoms, but for those who do, common signs include:
- Sensation of skipped or fluttering heartbeats
- Palpitations or abnormally fast heart rate
- Fatigue or reduced stamina
- Dizziness or lightheadedness
- Shortness of breath
- Chest pain
Diagnosis of Atrial Fibrillation (AF)
Atrial fibrillation is an abnormal heart rhythm that requires accurate and thorough diagnosis. Physicians use several diagnostic methods to assess heart function in detail, including:
- Electrocardiography (ECG / EKG)
This is a standard test that can be performed immediately at the hospital. However, for paroxysmal atrial fibrillation (PAF)—which comes and goes—this test might not detect the condition. Today, mobile apps compatible with devices like iPhones, Samsung, or Huawei smartphones can be paired with portable ECG monitors to help detect irregular rhythms and share results with doctors for further evaluation. - Holter Monitor (Continuous ECG Monitoring)
For patients with intermittent symptoms, doctors may recommend wearing a portable ECG device on the chest for 24–48 hours (or longer). This allows for continuous heart rhythm monitoring, increasing the chances of detecting abnormal rhythms that may not appear during a brief in-office ECG. - Exercise Stress Test
This test evaluates heart function during physical activity, such as walking or running on a treadmill, while monitoring the ECG. It helps assess how well the heart pumps blood and oxygen under stress, and is useful for detecting arrhythmias triggered by exertion or evaluating underlying coronary artery disease. - Echocardiogram (Heart Ultrasound)
This imaging test uses high-frequency sound waves to create real-time images of the heart. It assesses heart size, muscle function, valve movement, and blood flow within the chambers. It is particularly helpful in identifying the cause or consequences of atrial fibrillation. - Coronary Angiography (CAG)
In cases where coronary artery disease is suspected, doctors may recommend coronary angiography. This procedure involves inserting a small catheter through the wrist or groin and injecting a contrast dye to visualize the heart’s blood vessels using X-ray imaging. It helps diagnose blockages that could be contributing to abnormal heart rhythms.
The choice of diagnostic method depends on the patient’s symptoms and the physician’s clinical judgment.
If you experience symptoms such as palpitations, dizziness, or unusual fatigue, it’s important to undergo a comprehensive cardiac evaluation by a specialist to prevent potential long-term complications.
Treatment of Atrial Fibrillation (AF)
The primary goals in treating atrial fibrillation (AF) are to control the heart’s rhythm, reduce the risk of blood clot formation, and prevent complications. Treatment plans vary depending on the individual’s symptoms, underlying causes, and existing medical conditions. Key treatment approaches include
- Lifestyle Modifications
This is a cornerstone for reducing overall health risks and managing chronic conditions such as diabetes, high blood pressure, and high cholesterol. Proper control of these diseases is essential.
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- Maintain a healthy weight through diet and regular exercise
- Avoid high-risk behaviors like smoking and excessive alcohol consumption
- Manage stress effectively and ensure adequate sleep
- These steps help support mental well-being and boost immune function
- Rhythm Control
The goal is to restore a normal heart rhythm, which can be achieved through:
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- Antiarrhythmic medications such as flecainide or amiodarone
- Electrical cardioversion, which delivers an electric shock through electrodes placed on the chest to reset the heart’s rhythm
- Catheter ablation, a minimally invasive procedure using catheters to destroy areas in the heart that trigger abnormal electrical signals—recommended for those who do not respond to medication or have recurring, severe symptoms
- Rate Control
If restoring a normal rhythm isn’t possible, the focus shifts to slowing the heart rate to improve efficiency and reduce symptoms. This may involve:
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- Beta-blockers, calcium channel blockers, or digoxin
- In some cases, a pacemaker may be implanted if the patient also has a slow heart rate
- Stroke Prevention
Because AF increases the risk of blood clots and stroke, doctors often prescribe anticoagulant therapy, such as:
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- Warfarin (requires regular INR blood monitoring)
- Newer oral anticoagulants (NOACs) like dabigatran, rivaroxaban, or apixaban, which are more convenient as they don’t require frequent blood tests
Each treatment plan should be tailored to the patient’s unique condition and monitored regularly by a cardiologist to ensure the best possible outcomes and quality of life.
The choice of medication depends on factors such as age, underlying conditions, risk of bleeding, and the CHA₂DS₂–VASc score, which assesses the risk of stroke in patients with atrial fibrillation.
Atrial fibrillation is a common condition, especially among the elderly and individuals with chronic illnesses such as high blood pressure, diabetes, or other types of heart disease. In some cases, the condition may be asymptomatic, but if left undiagnosed and untreated, it can significantly increase the risk of serious complications such as ischemic stroke (due to blood clots) or heart failure.
Early detection and proper treatment by a cardiac specialist can significantly reduce these risks, allowing patients to live safely and enjoy a better quality of life.
Therefore, if you experience palpitations, unusual fatigue, shortness of breath, or suspect that you might have an irregular heartbeat, it is important to undergo a thorough evaluation by a cardiologist.
At Phyathai 2 Hospital, we offer comprehensive cardiac care led by a team of experienced heart specialists, supported by advanced diagnostic tools and international-standard treatment protocols. From risk assessment, ECG, and Holter monitoring to tailored treatments—including medications, lifestyle modification, and specialized procedures—we provide holistic and individualized care.
Taking care of your heart begins with being mindful of your health. If you have any concerns or notice unusual symptoms, consult a medical professional—because a “well-rhythmed heart” is the foundation of a healthy life.
