What is Atrial Fibrillation?
Atrial fibrillation is the most common heart rhythm condition in Australia. It occurs when the electrical signals that coordinate your heartbeat become chaotic, causing the top chambers of your heart (the atria) to quiver rather than beat properly. This can lead to a fast, irregular heartbeat and affect how well your heart pumps blood.
Atrial fibrillation can feel unsettling—but it is manageable. With the right care and support, most people can live full, active lives.
Watch: Dr John Hayes explains ‘What is Atrial Fibrillation’
In this video, Dr John Hayes provides a brief overview of important facts to know about AFib, including:
- What is Atrial Fibrillation?
- What are the common symptoms?
- What happens in your heart during an AFib episode?
- How is AFib typically diagnosed?
Symptoms of Atrial Fibrillation
Some people with atrial fibrillation experience no symptoms at all. Others may notice:
- A fluttering or pounding heartbeat
- Shortness of breath
- Fatigue, even after light activity
- Dizziness or faintness
- Anxiety or chest discomfort
Even if symptoms come and go, atrial fibrillation still requires a medical diagnosis, and may need specific management of the condition and other risks. Left untreated, it can increase the risk of stroke and heart failure.
Atrial Fibrillation as a Progressive Condition
Atrial fibrillation is a long-term condition that often begins with occasional, short episodes and can progress to more sustained forms. Even when people with atrial fibrillation are in normal rhythm (sinus rhythm), there are changes occurring in their heart tissues over time that gradually make atrial fibrillation rhythm episodes more frequent and more difficult to revert back to normal rhythm.
Progression of Atrial Fibrillation
- Paroxysmal atrial fibrillation: Episodes come and go, usually resolving on their own within hours or up to 7 days.
- Persistent atrial fibrillation: Episodes last longer than 7 days and may require medical intervention to stop.
- Permanent atrial fibrillation: Ongoing rhythm, where rhythm control is no longer pursued.
Understanding where you are in this progression helps guide different types of treatment strategies. That’s why the specialist cardiac electrophysiologist cardiologists at QCG treat atrial fibrillation as a long-term condition and will adjust the goals of treatment and management strategies over time.
Causes and Risk Factors for Atrial Fibrillation
While there isn’t a clear, single cause of atrial fibrillation as a long-term cardiac condition, it’s usually associated with specific risk factors and with remodelling of the heart tissue over time. Sometimes episodes of the atrial fibrillation rhythm can be triggered by various factors too.
Risk Factors
Risk factors for atrial fibrillation are a range of factors that can make it more likely for you to develop atrial fibrillation, as well as influencing the progression of the condition.
Non-Modifiable Risk Factors:
- Getting older (especially over 65)
- Family history of atrial fibrillation
Modifiable Risk Factors:
- High blood pressure
- Heart disease or previous heart attack
- Obesity
- Diabetes
- Sleep apnoea
- Alcohol or stimulant use
- Smoking
Addressing these risks, adjusting lifestyle factors, and treating medical conditions can reduce the risk of atrial fibrillation developing or slow its progression.
Cardiac Remodelling
Over time, atrial fibrillation itself can lead to changes in the heart’s structure and electrical pathways—a process known as remodelling. This can involve:
- Fibrosis (scarring) of the heart tissue
- Changes in the conduction pathways that regulate rhythm
- Stretching and enlargement of the atria (upper chambers of the heart)
This creates a self-perpetuating cycle: the more episodes of atrial fibrillation occur, the more the heart remodels—and the more likely further episodes become. This is often summed up by the phrase, “atrial fibrillation begets atrial fibrillation.”
Remodelling is why it’s important to diagnose and treat atrial fibrillation early. Delaying intervention can make the condition harder to reverse and reduce the effectiveness of treatments like ablation.
Triggers of Atrial Fibrillation Episodes
While risk factors and remodelling increase your overall susceptibility, episodes of atrial fibrillation can still be triggered by temporary or external factors. While these are not technically the ‘cause’ of atrial fibrillation as a condition, they can sometimes stimulate an episode of atrial fibrillation rhythm. Common triggers reported by patients include:
- Sudden alcohol intake (“holiday heart” syndrome)
- Intense stress or anxiety
- Stimulants (including caffeine or medications like decongestants)
- Dehydration or illness
- Sudden physical exertion
- Hormonal changes (e.g. in thyroid function)
Identifying and avoiding these triggers can help reduce the frequency of episodes—especially in early or paroxysmal atrial fibrillation. At QCG, we work with you to understand your personal patterns and guide you on prevention strategies tailored to your lifestyle.
How Atrial Fibrillation is Diagnosed
The main way that atrial fibrillation is diagnosed is through capturing the heart rhythm during an episode with an ECG (electrocardiogram), which records the electrical activity of your heart. Because atrial fibrillation can be intermittent, extended monitoring may be needed. Your doctor (your GP or cardiologist) will also do a thorough interview to understand your symptoms and other contributing factors. It is also common to have other cardiac tests like an echocardiogram, to check the structure and function of your heart.
What if it is difficult to catch an ECG during an episode?
We understand that particularly for people with paroxysmal atrial fibrillation, you may not be in an episode for it to be captured on ECG at the time of your appointment. Your doctor may recommend some more extended ECG tests, such as:
- Holter monitors (24–72 hours)
- Event recorders (for longer periods)
- A wearable ECG smartwatch or other device with a medical-grade ECG
The sooner atrial fibrillation is diagnosed, the sooner you can take control.
Is Atrial Fibrillation Dangerous?
Atrial fibrillation is not usually life-threatening on its own—but it does raise the risk of stroke by up to five times. When your heart doesn’t beat properly, blood can pool and form clots. If a clot travels to the brain, it can cause a stroke.
It can also weaken your heart over time, leading to heart failure if left untreated. That’s why early, proactive care matters.
How is Atrial Fibrillation Treated?
Treatment for atrial fibrillation is based on the internationally recognised Four Pillars of Atrial Fibrillation Management:
- Stroke Prevention – reducing your risk of blood clots and stroke with medication or procedures.
- Rhythm Control – restoring or maintaining normal heart rhythm through medications or ablation.
- Rate Control – slowing the heart rate if atrial fibrillation becomes permanent.
- Lifestyle Management – addressing risk factors like sleep apnoea, alcohol, weight, and stress.
At QCG, we personalise your treatment based on your symptoms, health history, and goals. For a more in-depth look at how we manage atrial fibrillation, including detailed treatment options and procedures:
Living With Atrial Fibrillation
Atrial fibrillation is a long-term condition, but it doesn’t have to define your life. With regular check-ups, personalised care, and lifestyle changes, many people feel better and live longer.
At QCG, we support you with education, heart rhythm specialists and a team that walks beside you every step of the way.
Your Care with QCG
We combine expert cardiology with genuine compassion. At QCG, you’ll have access to:
- Advanced diagnostics and rhythm mapping
- Leading ablation and device therapies
- Collaborative care teams
- Regional outreach and telehealth support
You’re never just a number. You’re a person with a unique story—and we’re here to listen and help.
Frequently Asked Questions
Episodes may come and go, especially in paroxysmal atrial fibrillation, but underlying changes often make it a lifelong condition.
Yes—assessment is essential to manage stroke risk and long-term complications.
