Skipping A Beat

If your heart has an irregular rhythm, you may be suffering from atrial fibrillation (AF), a relatively common condition that can have serious consequences. We find out all about it from Dr Jo Jo Hai Siu Han

- Dr Jo Jo Hai Siu Han

What causes AF?

AF is a very complex disease. It can occur “de novo”, which means it happens on its own, or it can be associated with other conditions, from binge drinking to structural heart diseases. Depending on the cause, it can affect people from different age groups.

How common is it?

Rates of prevalence depend on how you screen people for it. AF is an interesting disease; it can happen in a paroxysmal form, where it comes and goes; or it can be persistent, or always there. In this persistent form, it’s easy for a doctor to pick up. If it comes and goes, we mightn’t pick it up so easily – particularly if a patient doesn’t have symptoms.

Having said that, the prevalence has been reported as one to four percent – really quite significant. It affects the elderly the most, because many of them have existing cardiovascular diseases such as hypertension or coronary artery disease. If you count people aged from birth to 60 years, the prevalence is around one to two percent. By the age of 80, 10 to 20 percent of people will have AF.

Is tachycardia the same as atrial fibrillation?

Tachycardia literally means a fast heart rate – usually a heart rate above 100 beats per minute is described as tachycardia. However, this can be caused by many conditions. For example, when you’re anxious or when you’re exercising, you have a physiological form of tachycardia.

AF, on the other hand, is not physiological, it’s pathological; this means the heart can beat quickly, but without a “need”. So, in patients with AF, the fast heart rate happens without them needing it – and that’s the problem.