What are the first signs of atrial fibrillation?

The first signs of atrial fibrillation may be an irregular or racing heartbeat, palpitations, breathlessness, tiredness, dizziness or reduced exercise tolerance. Episodes can start suddenly, come and go, or remain unnoticed until a pulse check or medical test finds an irregular rhythm.

Atrial fibrillation is an irregular rhythm arising in the heart’s upper chambers. The heartbeat may feel uneven, fluttering, pounding or unusually fast, and the pulse can vary from beat to beat. Reduced filling time can leave you short of breath or tired during ordinary activity. Similar sensations can come from stress, stimulant drinks, thyroid problems, anaemia or other heart rhythms, so symptoms cannot identify the cause by themselves.

Arrange medical assessment for a new irregular pulse, repeated palpitations, unexplained breathlessness or a noticeable drop in stamina. Note when episodes begin, how long they last, whether the rhythm feels regular, and any chest discomfort or dizziness. An Electrocardiogram can record the rhythm; a longer monitor may be considered when episodes are intermittent. Do not begin or stop heart medicines without advice.

Call emergency services for palpitations with chest pain, severe breathlessness, fainting, collapse, confusion or sudden weakness. Sudden facial drooping, speech difficulty, one-sided numbness or vision change may indicate a Stroke or Transient Ischaemic Attack and require immediate help. Do not drive yourself.

Ask whether you need an Electrocardiogram or rhythm monitor, what may have triggered the rhythm, and how to check your pulse. Discuss stroke prevention, including whether Anticoagulation Management is appropriate, and which symptoms should prompt urgent review.