When An Irregular Heartbeat May Point To Atrial Fibrillation
Have you ever felt your heart flutter for a few seconds and wondered whether it was normal? Or noticed your smartwatch flag an irregular rhythm, only to dismiss it because you felt fine? Most of the time, an odd beat here or there is not a cause for concern. But some irregular heartbeats have a specific pattern behind them, and that pattern has a name worth knowing.
This article walks you through what atrial fibrillation is, how it may feel, why it matters, and when a review with a cardiologist may be worth considering.
Atrial fibrillation in plain terms
Atrial fibrillation, often shortened to AFib, is a type of irregular heart rhythm. Instead of the heart's upper chambers beating in a steady, coordinated way, they quiver in a disorganised rhythm. This causes the whole heart to beat irregularly, sometimes faster than usual, sometimes slower.
Atrial fibrillation is one of the most common heart rhythm conditions, particularly in adults over 60. It can come and go in brief episodes, or it can become a more persistent pattern over time.
Because AFib can be silent or subtle, many people live with it for months or years before it is picked up.
What atrial fibrillation may feel like
So how do you know if what you are feeling might be atrial fibrillation? The experience can vary widely. Some people notice clear symptoms, while others feel nothing at all. Common experiences include:
A fluttering, racing, or pounding sensation in the chest
A heartbeat that feels irregular or uneven
Brief moments of breathlessness
Unusual tiredness, especially with light activity
Light headedness or a sense of feeling faint
Chest discomfort or a vague sense that something is off
No symptoms at all, with AFib only picked up during a routine check
A simple way to compare sensations, not a diagnosis
Occasional skipped beats are common and often harmless
An irregular rhythm that lasts for many minutes or hours may deserve closer attention
Symptoms combined with a wearable alert are more meaningful than either sign alone
These are patterns, not rules. Context matters.
Why atrial fibrillation matters
If AFib can be silent or feel mild, why does it get so much attention? Because the risks it carries are not always in proportion to how it feels.
Atrial fibrillation is recognised as one of the leading causes of stroke, and this is one of the most important reasons it is taken seriously. When the heart's upper chambers do not beat in a coordinated way, blood can pool in areas where it should be moving, which raises the chance of clot formation. If a clot travels to the brain, a stroke can occur. Reducing that risk is a central part of why proper identification matters.
Over time, atrial fibrillation may also contribute to:
Heart failure, particularly if the rhythm stays fast for long periods
Worsening of existing heart disease [link → existing "How common is heart disease in Singapore" blog]
Reduced exercise tolerance and daily energy
A greater risk of hospital visits for related complications
The good news is that when AFib is identified, there are clear steps that can reduce these risks meaningfully. This is why picking it up matters, even when it feels mild.
What may trigger or contribute to atrial fibrillation
Atrial fibrillation does not have a single cause. It is often the result of several factors overlapping. Common contributors include:
Age, particularly over 60
High blood pressure, especially if untreated for a long time
Existing heart conditions such as coronary artery disease or heart failure
Thyroid imbalance, particularly an overactive thyroid
Excessive alcohol intake
Sleep apnea
Diabetes
A family history of atrial fibrillation
Physical or emotional stress
Being in one or more of these groups does not mean you have AFib. It simply means it may be worth staying aware of the signs, particularly if you notice new palpitations or irregular rhythm alerts.
How atrial fibrillation is picked up
How do you actually find out whether you have AFib? Because the rhythm can come and go, it can be tricky to catch. Common ways it is identified include:
A routine ECG during a health check
A wearable device flagging an irregular rhythm
A Holter monitor worn for 24 hours or longer to catch episodes over time
Symptoms noticed during exercise or after certain triggers
Smartwatches have made it much easier to detect atrial fibrillation in Singapore, especially for people who may not have obvious symptoms. Many people first learn of possible AFib when their watch sends an alert, even before they see a doctor.
When to consider a review
So when might it be worth checking in with a cardiologist? Signs worth reviewing can include:
Wearable alerts for irregular rhythm, particularly when combined with symptoms
Episodes of palpitations lasting more than a few minutes
Unexplained tiredness, breathlessness, or reduced exercise tolerance
A racing or irregular heartbeat that seems to come without a clear trigger
Existing heart conditions or risk factors alongside new symptoms
Family history of atrial fibrillation with any of the above
These features do not confirm atrial fibrillation on their own. They are reasons to consider a review rather than to dismiss the pattern.
How atrial fibrillation is usually assessed
At Sunrise Heart Specialist Clinic in Sembawang, a cardiologist-led review usually begins with a conversation about your heart rhythm, any symptoms you have noticed, and your general heart health history. This may include:
When and how often the irregular rhythm occurs
Symptoms occurring alongside, such as breathlessness, dizziness, or fatigue
Any wearable alerts or recorded episodes
Medications, alcohol use, and lifestyle factors
Personal and family history
Depending on the clinical context, investigations may be considered, such as an ECG (heart tracing) to look at the rhythm in real time, a Holter monitor to track patterns over 24 hours or longer, an echocardiogram to look at how the heart is functioning, or blood tests to check for contributing factors such as thyroid imbalance. The appropriate approach depends on your individual presentation.
Where Sunrise Heart Clinic may fit into next steps
If your smartwatch has flagged an irregular rhythm, or you have been noticing palpitations that feel different from your usual, that uncertainty alone is often reason enough to check in.
At Sunrise Heart Specialist Clinic in Sembawang, Dr Woo Jia Wei works with patients across Singapore who want a clearer understanding of what their heartbeat patterns may be showing.
For those who find travelling to a clinic difficult, whether due to age, mobility, or family commitments, home cardiology visits are also available across Singapore. Many families find this an easier way to arrange care for elderly parents or loved ones who prefer being seen at home.
Book a cardiac review with Dr Woo Jia Wei at Sunrise Heart Specialist Clinic in Sembawang. Clinic appointments and home cardiology visits across Singapore are both available.
FAQ
Are my smartwatch AFib alerts reliable?
Modern smartwatches have become significantly more reliable at detecting irregular rhythms, and they are one of the most common ways AFib is first noticed today. That said, alerts can occasionally be false positives, and they do not replace a proper cardiac review. If your device flags an irregular rhythm, especially more than once, it is worth having the finding assessed.
Can I have atrial fibrillation without feeling anything?
Yes. Silent AFib is more common than many people realise, particularly in older adults. This is one of the reasons routine checks and wearable alerts can be useful, since the condition can carry meaningful risks even without symptoms.
Is atrial fibrillation dangerous?
Atrial fibrillation itself is not immediately life threatening for most people. The main concern is the increased risk of stroke and, over time, heart strain. When AFib is identified, there are effective ways to reduce these risks meaningfully, which is why picking it up matters.
Can atrial fibrillation come and go?
Yes. Many people experience AFib in episodes, sometimes only minutes long, before it becomes more persistent. This on and off pattern is one of the reasons a single ECG may miss it, and why a Holter monitor is often used to track rhythm over a longer period.
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