Medical Q&As

Atrial fibrillation - detection?

Can atrial fibrillation be detected by constant monitoring over a 24-hour period when that test is repeated once ever 3 months? Or, is atrial fibrillation so intermittent that continuous monitoring over a longer period than one day is needed? What symptoms would I have if I had atrial fibrillation?

Atrial fibrillation is the commonest rhythm disturbance of the heart that we encounter in general practice. It is an irregular and often rapid beating of the atria or upper chambers of the heart. Most cases can be readily diagnosed by simply feeling the personís pulse. However, sometimes the nature of the rhythm disturbance may not be apparent on feeling the pulse but the ECG usually resolves such uncertainty. Most cases of atrial fibrillation are continuous, which means that the rhythm disturbance is constantly present. However, it can also be intermittent, which means that it might not be detected by ECG or by examination of the pulse. In other words the rhythm disturbance may have lapsed back into normal rhythm at the time of the examination. In such situations Holter monitoring can be very useful. Holter monitoring is the technical name for the 24-hour ECG that you refer to in your question. It would be highly unusual for atrial fibrillation to escape notice through a combination of pulse examination, standard ECG and Holter monitoring. Therefore it would not be usual to require continuous monitoring for longer than a day. With regard to symptoms it is important to emphasise that the condition can be symptomless. However, many sufferers do complain of palpitations. Some sufferers may also complain of breathlessness and in some cases the rhythm disturbance may not come to light until an acute event such as stroke occurs.