Atrial Fibrillation (AFib) Assessment
Living with atrial fibrillation can be unsettling, especially when symptoms begin to affect your daily life. As an EHRA-certified invasive electrophysiologist, my service is designed to provide clarity, creating a clear path toward diagnosis and treatment of Atrial Fibrillation. If you are experiencing new symptoms, seeking a second opinion or looking for advanced treatment options, you’ll benefit from expert, personalised care from me, a dedicated heart rhythm specialist who focuses exclusively on diagnosing and treating arrhythmias.
What is Atrial Fibrillation?
Atrial fibrillation is a type of arrhythmia, which causes your heart to beat too slowly, too quickly or irregularly. Atrial fibrillation happens when the electrical signals in the upper chambers of your heart (atria) don’t get sent out properly. Your heart chambers should be steady and regular, but instead they can quiver, which is referred to as fibrillation. Combined, this causes your heart to beat randomly, which impacts its ability to effectively pump blood.
Risks of Atrial Fibrillation
AFib can lead to serious health issues. One of the biggest risks of atrial fibrillation is a stroke, where blood clots formed in the heart travel to the brain. There's also a risk of heart failure, where the heart just can't pump blood as effectively as it should.
Symptoms of Atrial Fibrillation
Living with AFib can feel different for everyone, and at my atrial fibrillation clinic, I understand that approaching your circumstance requires personalised attention. Whilst individual experiences of atrial fibrillation differ, many report the following as common symptoms of atrial fibrillation:
Palpitations- Some might notice their hearts fluttering or pounding, like a bird trapped in their chest.
Finding it harder to exercise
Persistent tiredness
Shortness of breath
Dizziness or feeling faint
Increased sweating
If you are experiencing any of these symptoms, you can book an appointment at my atrial fibrillation clinic for a personalised assessment, to gain guidance, clarity and a treatment plan from an EHRA-certified cardiologist.
What are the different types of atrial fibrillation?
There are four types of atrial fibrillation, which all require different management approaches ranging from daily monitoring to surgical intervention. The classification of AFib depends on how often the irregular heartbeats occur and how long they last. At my clinic, I am able to assess your symptoms and monitor your heart rate to determine which type of AFib you have.
Paroxysmal Atrial Fibrillation
This type of atrial fibrillation is characterised by intermittent episodes which typically last from a few minutes to hours. Typically, paroxysmal episodes stop on their own within 7 days, with most episodes resolving within 24 hours. In some ways, the unpredictable change between being in a normal rhythm and being in atrial fibrillation can be more of a nuisance, even when the percentage of time out of normal rhythm isn’t very high.
Persistent Atrial Fibrillation
When atrial fibrillation lasts longer than 7 days and is considered suitable for medical intervention, it is known as persistent AFib. You may have no symptoms at all, but it’s important to assess the risk of stroke and degree of heart muscle impairment to see if these more dangerous consequences of atrial fibrillation need treatment.
Long-Standing Persistent Atrial Fibrillation
Experiencing continuous atrial fibrillation, which has lasted for 12 months or longer, is referred to as long-standing persistent atrial fibrillation. The difference seems minor, but the longer your heart is in atrial fibrillation, the more difficult it can be to restore normal rhythm. In this classification, active efforts to restore the normal heart rhythm are still under consideration.
Permanent Atrial Fibrillation
Continuous AFib is where the patient and doctor have accepted the condition, and no further attempts to restore or maintain a normal heart rhythm are being pursued. Permanent atrial fibrillation is often managed by medication prescribed by a doctor, such as beta-blockers, calcium channel blockers or digoxin, which can slow the heart rate to a comfortable and safe level, together with stroke prevention medication or pacemaker and AV node ablation, which is a drug-free way to control the heart rate without affecting the rhythm of the atrium.
Causes of Atrial Fibrillation
The most common conditions associated with atrial fibrillation are:
High blood pressure
Sleep apnoea
Excessive alcohol consumption
Heart valve disease
Congenital Heart Disease
Pericarditis
Cardiomyopathy
Coronary heart disease
Diabetes
Living with obesity
Surgery on your heart
Stress
Sick sinus syndrome
Pulmonary embolism
AFib triggers also include
Alcohol, even in small quantities
Caffeine
Smoking
Recreational drugs
Spicy food
Diagnosing Atrial Fibrillation
I primarily diagnose atrial fibrillation through an electrocardiogram (ECG), which records your heart's electrical signals by using sticky sensors which are attached to your chest and limbs. As part of a comprehensive assessment, we also scan the heart with an echocardiogram, which takes an ultrasound of the heart using sound waves to evaluate valves and overall structure.
As atrial fibrillation episodes can be intermittent, a single ECG may not always catch it. In these cases, doctors utilise long-term monitoring devices to track heart rhythms during daily activities. This often includes one of the following;
Holter monitor
This is a portable device worn continuously for 1-2 days to monitor heart rhythms during everyday activities.
Event monitor
These are worn for a maximum of 30 days, recording your heart’s activity when you activate it during symptoms. This allows for pattern identification over the period.
Implantable loop recorder
This is a device which is inserted under the chest that monitors your heart for 3 years. This is often the diagnostic technique when symptoms of atrial fibrillation are very rare and short-lived.
Additional assessments for Atrial Fibrillation
Often, blood tests are used to determine electrolyte balances and thyroid hormone levels, as these often trigger AFib.
Some smart watches and widely available ECG devices can detect abnormal rhythms and are increasingly playing a helpful role in alerting patients and doctors to underlying AFib.
Treatment for Atrial Fibrillation
At my clinic for Atrial Fibrillation, I will discuss the available treatments for atrial fibrillation, finding the most suitable approach for you depending on your symptoms of AFib.
Medication
Medication to treat Atrial Fibrillation typically falls into three categories:
Anticoagulants, which are blood thinners used to reduce the likelihood of strokes,
Rate controllers, which are used to slow the heart rate
Rhythm controllers, also known as anti-arrhymics, are used to maintain a normal heartbeat. The medication prescribed depends on your specific symptoms.
Cardioversion
Cardioversion is sometimes offered as a treatment for atrial fibrillation, as it supports the return to a normal heart rhythm.
There are two types of cardioversion.
Electrical cardioversion, which is done using a defibrillator to send controlled electric signals to your heart through electrodes placed on the chest. Due to this, it is also referred to as DC cardioversion or direct current cardioversion.
Chemical cardioversion, sometimes referred to as pharmacological cardioversion. This is achieved using medicine which is either swallowed or received through an infusion into a vein (an IV).
Ablation
One of the most common treatments for atrial fibrillation is ablation. Catheter ablation is performed by a cardiologist specialised in invasive investigation and treatment of heart rhythm problems, known as an electrophysiologist, in a specialised electrophysiologic lab.
Lifestyle Changes
On top of adhering to professionally recommended medical treatment or intervention, it is important to consider several lifestyle changes. For example, being overweight can put a strain on the heart by surrounding the heart with fatty deposits and increasing the risk of high blood pressure and sleep apnoea, increasing the risk of AFib recurrence.
Regular exercise routine
Adhering to a regular exercise routine which incorporates at least 150 minutes of moderate aerobic exercise per week. This can support weight loss goals whilst reducing blood pressure.
Eating a heart-healthy diet
By reducing your intake of sodium, saturated fats and added sugars, you can keep your blood pressure and blood sugar levels stable. Popular diets to support this include the Mediterranean diet. For weight loss, many patients succeed with some form of fasting such as the 5:2 diet or dietary hacks such as the low carbohydrate diets.
Stress and sleep management
High stress and anxiety are common triggers. Seeking therapeutic support and following daily meditation may support stress management techniques and reduce anxiety.
Sleep apnea can also be a good target for treatment. Being evaluated for a CPAP device can help with sleep apnea.
Limiting alcohol consumption can support a healthier heart, as even moderate consumption of alcohol can act as a trigger for atrial fibrillation, which means reducing the frequency of alcohol or abstaining completely can help prevent episodes.
What to expect at your initial Atrial Fibrillation session?
In your first session, you will have time to talk through your symptoms and understand your condition, as well as any immediate lifestyle changes you can make whilst awaiting further information. We will explore the most effective options for restoring rhythm and reducing long-term risks on your personalised treatment plan.
As an EHRA-certified invasive electrophysiologist, I will carry out a thorough rhythm assessment, which often includes:
A 12-lead ECG checks your heart's electrical activity
Review of your medical history, including any previous tests or smart device recordings
Discussion of any possible triggers such as alcohol intake, stress levels, sleep apnea or possible thyroid issues.
From this initial assessment, I may recommend additional diagnostic tools such as Holter monitoring, blood tests or echocardiography, allowing me to build a comprehensive approach to your heart rhythm.
I will explain what type of AFib you have, the possible causes, your stroke risk, how this is assessed and how your AFib may progress without treatment.
Your initial consultation will conclude with a tailored plan based on your symptoms, lifestyle, diagnosis, and treatment of atrial fibrillation. You’ll leave our consultation with a feeling of clarity, a structured pathway with practical guidance from a dedicated heart rhythm specialist supporting you with your AFib management.
Why choose Dr Chris Skene for your Afib assessment
Choosing the right specialist is one of the most important decisions you can make when living with atrial fibrillation. At my private clinic, you receive expert, personalised care from the outset. With over 25 years dedicated to arrhythmia care, I bring EHRA-certified expertise in electrophysiology, catheter ablation, pacemaker and defibrillator implantation supported by my training at the University of Edinburgh and PhD at University College London. I have led innovative rhythm services within the NHS, performing thousands of life-saving procedures, consistently exceeding the benchmark 50 annual ablations research has found to be associated with better outcomes.
My private practice offers fast, reliable access to specialist diagnostics, personalised treatment plans and advanced AFib therapies delivered with precision and compassion. Book your AFib appointment to understand your symptoms and receive expert assessment and guidance.