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 across East and Southeast Asia alongside ageing populations and increasing rates of high blood pressure.
Medicines used to treat Atrial Fibrillation
Digoxin Tablets
0.25mg
Designed to support heart rhythm regulation, indicated to manage chronic heart failure.
Warfarin Tablets
1 · 2 · 5mg
Formulated for thromboembolism to mitigate clotting risks.
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.