Hyderabad, 20 Aug 2026: A heartbeat that occasionally races, flutters or feels irregular is easy to dismiss. So are unexplained tiredness, breathlessness or a gradual reduction in exercise capacity. But in some people, these could be signs of Atrial Fibrillation, or AFib, an abnormal heart rhythm that deserves far greater public awareness.

More importantly, AFib does not always produce obvious symptoms. This means that for some people, the first indication of the condition may come only when it is detected during a routine examination or evaluation for another health problem.

Bringing focus to this important yet under-recognised heart rhythm disorder, Prof. Dhiraj Gupta, world-renowned cardiac electrophysiologist from Liverpool, UK, and Dr. C. Narasimhan, Director & HOD, Electrophysiology Services, AIG Hospitals, came together for an interaction centred on AFib awareness, its consequences and the importance of recognising it early.

AFib occurs when the electrical activity in the upper chambers of the heart becomes disorganised, causing the heart to beat irregularly. While some patients experience noticeable palpitations, dizziness or breathlessness, the condition can also occur with relatively few symptoms.

One of the most serious concerns associated with AFib is stroke.

When the upper chambers of the heart do not contract normally, blood can stagnate and form clots. If a clot travels to the brain, it can cause a stroke. This is why detecting AFib is not simply about correcting an uncomfortable or irregular heartbeat; it can also provide an opportunity to identify an individual's stroke risk and initiate appropriate preventive treatment.

Modern AFib management therefore looks at the patient as a whole. The 2024 European Society of Cardiology guidelines describe an AF-CARE approach that brings together management of associated diseases and risk factors, prevention of stroke and thromboembolism, control of heart rate and rhythm, and continued reassessment of the patient over time.

This is perhaps one of the biggest awareness gaps.

A person with AFib need not necessarily have severe chest pain or collapse. Symptoms, when present, can include an irregular or racing heartbeat, palpitations, breathlessness, dizziness or reduced ability to exercise. In others, the rhythm abnormality may be discovered incidentally.

The message for the public is therefore not to panic over every variation in heartbeat, but also not to repeatedly ignore an unexplained irregular pulse or recurring symptoms simply because they appear mild.

Evaluation is particularly relevant when such symptoms recur or when an individual has other cardiovascular risk factors.

The ability to identify rhythm abnormalities is also changing. Routine pulse checks, ECGs and longer-duration rhythm monitoring remain important clinical tools, while watches and other consumer devices increasingly make people aware that their heartbeat may be irregular.

Such alerts can be useful prompts to seek medical evaluation, but an alert from a wearable is not, by itself, a substitute for proper clinical assessment and confirmation of AFib.

Once diagnosed, treatment is individualised. Depending on the patient, it may involve management of underlying risk factors, medicines to control the heart rate or rhythm, anticoagulation to reduce stroke risk when clinically indicated, or advanced rhythm-control therapies such as catheter ablation in appropriately selected patients. Current international guidelines emphasise that AFib management should be dynamic and tailored to the individual rather than treated as a one-time intervention.

AFib is increasingly important as populations age and conditions associated with it become more common. International cardiovascular guidelines anticipate a substantial rise in the number of people living with AF over the coming decades, making awareness and early identification increasingly relevant to public health.

The takeaway is simple:

Recognising AFib early gives clinicians the opportunity to understand why it is occurring, assess the patient's individual stroke risk and decide whether treatment is required.

For the public, learning to pay attention to the rhythm of the heart may therefore be about much more than the heartbeat itself. In the right patient, identifying AFib early can become an important step towards preventing a far more serious cardiovascular event.