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Feeling your heart skip or flutter can be unsettling, but it does not always mean that something is seriously wrong. Atrial fibrillation, however, can go unnoticed for a long time and, if left undiagnosed, may increase the risk of serious complications.

Atrial fibrillation (AF) is the most common type of persistent heart rhythm disorder. Similar sensations can be caused by extrasystoles, also known as premature heartbeats. These are extra beats that occur outside the heart’s normal rhythm. They may feel like a brief pause or as though your heart has “skipped a beat” and are usually harmless.

Extrasystoles and atrial fibrillation: What’s the difference?

• Extrasystoles are occasional premature heartbeats that occur from time to time and are usually harmless.
• Atrial fibrillation causes the heart to beat irregularly and often more rapidly than normal. Because the upper chambers of the heart contract in a chaotic way, the risk of blood clots and stroke is increased.

“Based on the symptoms alone, it can sometimes be difficult to tell these rhythm disorders apart. An ECG can help determine what type of heart rhythm problem is present,” explains Professor Dr. Dirk Westermann, Medical Director of the Department of Cardiology and Angiology at the Medical Center – University of Freiburg.

Why early diagnosis matters

The earlier atrial fibrillation is detected, the sooner treatment can be tailored to the individual patient. Treatment does not necessarily involve a procedure. Depending on the situation, medication may be used to control the heart rate and reduce the risk of blood clots.

How can catheter ablation help?

If medication does not adequately control atrial fibrillation or episodes keep coming back, catheter ablation may be an option. This is a minimally invasive procedure that targets the areas of the heart responsible for triggering the abnormal rhythm.

A thin catheter is inserted through a vein in the groin and guided to the heart. The doctor uses it to identify the areas causing the abnormal electrical signals. These areas are most often located around the pulmonary veins. The tissue is then treated with heat or cold to block the abnormal signals and help the heart maintain a normal rhythm.

“Catheter ablation is a well-established and widely used treatment. In people with recurrent atrial fibrillation, it can reduce the frequency of episodes and help maintain a stable heart rhythm over the long term,” says Professor Westermann.

Catheter ablation may help to:

• reduce the frequency of atrial fibrillation episodes;
• relieve symptoms;
• improve exercise tolerance;
• help maintain a normal heart rhythm;
• improve long-term outcomes.

Whether catheter ablation is appropriate depends on several factors, including the patient’s age, other medical conditions, severity of symptoms, and how long they have had atrial fibrillation.

Checklist: When should you see a doctor?

You should consider seeing a doctor if:

• your heart suddenly starts racing or this happens repeatedly;
• your heartbeat feels irregular;
• you experience shortness of breath, dizziness, or weakness;
• you have risk factors such as high blood pressure, heart failure, or diabetes;
• you find that you are less able to cope with physical activity than before;
• you have never had an ECG;
• your symptoms persist for a long time or feel different from usual.