Doctor, I Was Told To Have Atrial Fibrillation
Patient: Doctor, I went for a routine check of my high blood pressure yesterday and I was told I have something called Atrial Fibrillation! What is this?
Doctor: Oh, I see. Don’t panic. Atrial Fibrillation, or “AFib,” or sometimes simply called “AF,” is the most common heart irregularity we see in medical practice. Simply put, it is a condition where the heart beats irregularly and usually very rapidly.
Patient: What exactly is happening inside the heart?
Doctor: Imagine your heart is a pump with four chambers. In a normal heartbeat, the top chambers (atria) contract smoothly to push blood down. In AFib, these top chambers just “shiver” or quiver chaotically instead of beating strongly. Because they don’t squeeze properly, blood can stagnate inside, like water in a pond that is not flowing.
Patient: And why is that dangerous?
Doctor: Stagnant blood can form clots. If a clot pumps out of the heart, it can travel straight to the brain and block a blood vessel, causing a Stroke (Paralysis). That is our biggest worry with AFib.
Patient: But I feel completely fine! I have no pain, no breathlessness. Should I still be worried?
Doctor: This is very common. Many patients are shocked because they have no symptoms. We call AFib an “alarm in silent mode.” Even if you feel fine, the risk of stroke is real. Feeling well does not always mean you are well.
Patient: How did they find it? How can you tell if someone has it?
Doctor: The surest way is an ECG, which records the electrical activity of your heart. But even checking your pulse can give a clue. If the pulse does not feel regular, like a drum beating without a rhythm, it could be AFib. Recently, I had a 68-year-old lady who just felt a bit dizzy. Her pulse was erratic, and the ECG confirmed AFib.
Patient: Can I check this at home? Do those smartwatches work?
Doctor: You can check your own pulse at the wrist to see if it is regular. Regarding technology, yes, modern devices like the Apple Watch, Samsung Galaxy Watch and many others are quite good at detecting irregular rhythms. They can alert you, but they are not a replacement for a doctor. If your watch warns you, or if you feel palpitations, meet your doctor for a proper diagnosis.
Patient: What caused this? Is it my diet?
Doctor: It can be many things. Long-standing High BP is a major cause. Thyroid problems, obesity, or even sleep apnea (snoring) can trigger it. Sometimes, it is related to lifestyle factors like excessive alcohol or caffeine.
Patient: Can it be cured with herbal medicines? I read somewhere that natural remedies work best.
Doctor: Please be very careful there. AFib is an electrical problem of the heart. While healthy food is good, there is no “herbal powder” that can repair the electrical circuit of the heart or dissolve a clot in the brain. Relying on unverified treatments for AFib can be very dangerous, especially if a stroke happens. We need proven medications to control the rate and avoid blood clots using blood thinners.
Patient: What about diet then? Does that help?
Doctor: Absolutely. Diet plays a huge role. For example, recent data tells us that drinking more than 2 litres of sweetened beverages (sodas, sugary juices) in a week increases AFib risk significantly. On the other hand, pure fruit juice without sugar seems to reduce the risk. Reducing salt is also important because it lowers your BP, which takes the strain off the heart.
Patient: So, I have to take medicines forever?
Doctor: In most cases, yes. We use medicines to keep the heart rate normal and “blood thinners” (anticoagulants) to prevent those dangerous clots. It is like carrying an umbrella… it does not stop the rain, but it keeps you dry (medicines keep you safe from stroke).
Patient: What if I don’t want to start treatment right away? I want to wait and see.
Doctor: I would strongly advise against that. AFib is a “stealthy” condition. The first symptom for many people is, unfortunately, a massive stroke. We want to prevent that disaster, not wait for it. Starting treatment now is your insurance policy against a future crisis.
Patient: Thank you, Doctor. I didn’t realize the stroke connection. I will start the treatment.
Doctor: You are making the right choice. Knowledge is power.
Dr. Shashikiran Umakanth (MBBS, MD, FRCP Edin.) is the Professor & Head of Internal Medicine at Dr. TMA Pai Hospital, Udupi, under the Manipal Academy of Higher Education (MAHE). While he has contributed to nearly 100 scientific publications in the academic world, he writes on MEDiscuss out of a passion to simplify complex medical science for public awareness.
