Melaka, 10 June – Atrial fibrillation (AF), a heart rhythm disorder that frequently causes no symptoms, is behind up to a quarter of all strokes in Malaysia, yet it remains widely undetected. A routine pulse check, taking less than 30 seconds, could change that.
Globally, AF accounts for 20 to 30 percent of all ischaemic strokes, according to the Framingham Study. In Malaysia, the Ministry of Health puts the figure at 15 to 25% locally, a substantial share driven by a condition most people have never heard of.
Dr Hartini Mohd Yusof, a triple-specialist in Cardiology, Electrophysiology and Internal Medicine at Oriental Melaka Straits Medical Centre, says AF is not getting the attention it deserves.
“Atrial fibrillation increases the risk of stroke by up to five times, yet it is one of the most preventable causes of stroke. The challenge is that many patients do not experience symptoms,” she said.
What makes AF particularly hard to catch is how quietly it operates.
“Up to 30 to 40 percent of individuals with AF are asymptomatic, what we call silent AF. Without detection and treatment, these individuals remain at significant risk, with stroke sometimes being their very first presentation,” she added.
Both the World Health Organisation (WHO) and the European Society of Cardiology recommend routine pulse checks as a frontline screening tool; no clinic, no equipment, no appointment required.
A normal pulse should feel steady and regular, between 60 and 100 beats per minute. Warning signs include an irregular or uneven rhythm, a fluttering sensation, or a heart rate that is unexpectedly fast or slow.
Those who notice any of these should seek medical attention promptly, with diagnosis typically confirmed through an electrocardiogram (ECG) or ambulatory heart monitoring, she explained.
The SAFE study found that routine pulse checks identified previously undiagnosed AF in approximately one to two per cent of older adults, a figure that, scaled across a population, represents thousands of potential early interventions.
Once AF is diagnosed, treatment is effective. Oral anticoagulants, commonly known as blood thinners, remain the cornerstone of stroke prevention, reducing risk by 60 to 70 per cent. Newer medications known as direct oral anticoagulants offer additional safety benefits, including a significantly lower risk of serious bleeding in the brain.
For selected patients, procedures such as catheter ablation or left atrial appendage closure may also be considered.
While AF risk increases with age, particularly in those 65 and above, the specialist reiterated that younger Malaysians with hypertension, diabetes or existing heart conditions should not assume they are in the clear.
Dr Hartini urged Malaysians to check their pulse regularly, keep blood pressure, diabetes and cholesterol under control, maintain a healthy lifestyle and attend regular health screenings.
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