ATRIAL fibrillation (AF), the world's most common arrhythmia, encountered in third of hospital admissions for cardiac rhythm disturbances. Before learning about its prevalence, lets understand what is AF.

AF is defined or described as an irregular heart rhythm (arrhythmia) that begins in the upper chamber of the heart (which is called as atria). In AF patients, the normal cycle of electrical impulses is interrupted leading to a fast, chaotic heart rhythm and poor movement of blood from atria to lower chambers (ventricles). AF often goes undetected and is associated with an increased risk of blood clots and stroke. It has been estimated that five? million Indians are affected by AF, based on ageing of the Indian population. Hypertension, diabetes mellitus and coronary heart diseases are the most common contributing risk factors for AF in Indians. Ac- cording to the reports from a recent study published in renowned journal, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. This indicates that, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF.

Signs and symptoms of AF

Sometimes, AF patients have no symptoms and their condition is only detectable upon physical examination. However, fluttering heartbeat or quivering (i.e., abnormal firing of electrical impulses causes the atria to fibrillate) are the most common symptoms of AF.

Patients may also experience one or more of the following symptoms:

• General fatigue
• A rapid and irregular heartbeat
• Fluttering or "thumping" in the chest
• Dizziness or light-headedness
• Shortness of breath and anxiety Weakness
• Faintness or confusion
• Fatigue when exercising
• Sweating
• Chest pain or pressure (angina)
• A feeling of butterflies or a fish flopping in your chest

AF patients should always be aware of warning signs of a heart attack or stroke.

Having AF can increase the risk for stroke and heart attack and hence it is important for any AF patients to know or to be aware of the warning signs.

Heart attack warning signs

• Chest discomfort: Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body: Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath: With or without chest discomfort.
• Other signs: Breaking out in a cold sweat, nausea or light-headedness.

Stroke warning signs

Stroke warning signs are collectively termed as FAST (i.e., Face drooping, Arm weak- ness, Speech difficulty and Time to act).

• Face drooping: One side of the patient's face droops or becomes numb? Ask the person to smile.
• Arm weakness: Is one arm weak or numb? Ask the person to raise both arms.
• Speech difficulty: Patient is unable to speak or repeat the sentence correctly.
• Time to act: If any of these signs are present, call emergency services immediately. Time is crucial in treating a stroke.