Plain English guide — what AF is, why stroke risk matters, and what treatment involves.
Atrial fibrillation (AF, or AFib) is the most common heart rhythm disorder. Instead of beating in a regular, coordinated rhythm, the upper chambers of the heart (atria) fire electrical signals chaotically — causing them to quiver rather than beat properly.
The result is an irregular and often fast heartbeat. The heart may beat at 100–175 beats per minute during AF (normal is 60–100), and the rhythm is unpredictably irregular.
The main concern with AF is not the irregular heartbeat itself — it's the risk of stroke. When the atria quiver instead of pumping, blood can pool and form clots. If a clot travels to the brain, it causes a stroke. AF is responsible for approximately 20–30% of all strokes in Australia. Source: Cardiac Society of Australia and New Zealand (CSANZ)
AF is usually diagnosed with an ECG (electrocardiogram) — a recording of the heart's electrical activity. It may be found:
Some people with AF have no symptoms at all — it is discovered only on an ECG during a check for something else. Others experience significant symptoms including palpitations (fluttering in the chest), shortness of breath, fatigue, dizziness, or chest discomfort.
Once AF is diagnosed, your GP will assess your stroke risk using the CHA₂DS₂-VASc score — a validated tool that assigns points for risk factors including age, sex, heart failure, hypertension, diabetes, prior stroke, and vascular disease. Source: CSANZ AF guidelines; ESC 2020
People with a CHA₂DS₂-VASc score of 2 or more (men) or 3 or more (women) are generally recommended anticoagulation — blood-thinning medication to prevent clots from forming. In Australia, direct oral anticoagulants (DOACs) such as apixaban and rivaroxaban are now preferred over warfarin for most people with AF.
Not everyone with AF needs anticoagulation — your GP and cardiologist will discuss the balance of stroke prevention benefits against the risk of bleeding for your specific situation.
AF is often a long-term condition. Management may include:
Many people with AF live full, active lives. Regular GP reviews and cardiology follow-up are important for monitoring and adjusting treatment over time.
Find condition-specific support organisations, helplines, and community services on helplines.com.au — Australia's directory of health and support services.
Find atrial fibrillation support → helplines.com.au👩⚕️ For clinicians: see the AF management reference — interactive CHA₂DS₂-VA + HAS-BLED, anticoagulation choice, rate vs rhythm, when to refer.