Atrial Fibrillation
Atrial fibrillation (AF) is the most common sustained heart rhythm disorder. The upper chambers of the heart beat chaotically instead of with a steady rhythm, which reduces pumping efficiency and allows blood to pool and clot. That clot risk is why AF is a leading cause of stroke. Prevalence rises sharply with age and is climbing alongside ageing populations and increasing rates of high blood pressure.
Digoxin Tablets
0.25mg
Digoxin 0.25mg tablets, used in the management of heart failure and atrial fibrillation. A cardiac glycoside that inhibits the sodium-potassium pump.
Warfarin Tablets
1 · 2 · 5mg
Warfarin 1mg, 2mg and 5mg tablets, used in the management of atrial fibrillation, thromboembolism and deep vein thrombosis. A vitamin K antagonist.
Key points
- Blood pooling in poorly contracting upper chambers is what makes atrial fibrillation such a strong risk factor for stroke.
- Some people notice palpitations, breathlessness or fatigue, while others have no symptoms and are diagnosed only after a routine ECG.
- Apixaban and dabigatran are newer alternatives to warfarin that need less dietary caution and offer steadier dosing.
What AF feels like
Many people notice a fluttering or racing sensation in the chest, shortness of breath, fatigue, or lightheadedness. Some feel nothing at all and AF is found incidentally on an ECG. Palpitations that come and go (paroxysmal AF) are common early on; over time the rhythm may become persistent.
Seek urgent care if AF is accompanied by chest pain, sudden weakness on one side of the body, or difficulty speaking, as these may signal a stroke.
How AF is managed
Treatment has two goals: controlling the heart rate or restoring normal rhythm, and reducing stroke risk.
Rate control keeps the ventricles from beating too fast. Digoxin has been used for decades and remains useful in certain patients. Sotalol and flecainide are used to maintain or restore sinus rhythm, particularly in paroxysmal AF without structural heart disease.
Stroke prevention is equally important. Warfarin was long the standard anticoagulant; newer options such as apixaban and dabigatran offer more predictable dosing with fewer dietary interactions. The choice depends on kidney function, other health conditions, and individual risk.
AF often sits alongside other heart and blood pressure conditions, and managing those underlying factors, controlling hypertension, treating sleep apnoea, reducing alcohol intake, can reduce how often episodes occur and how severe they feel.