A COMMON heart rhythm disorder that often causes no symptoms may be responsible for up to one in four strokes in Malaysia, with specialists warning that many cases remain undetected until it is too late.
Atrial fibrillation (AF), an irregular heartbeat that can increase stroke risk by up to five times, is estimated to account for between 15 and 25% of strokes in Malaysia, according to the Ministry of Health.
Dr Hartini Mohd Yusof, a consultant specialising in Cardiology, Electrophysiology and Internal Medicine at Oriental Melaka Straits Medical Centre, said AF remains one of the most preventable causes of stroke despite its significant impact.
“Atrial fibrillation increases the risk of stroke by up to five times, yet many patients do not experience symptoms and therefore remain unaware they have the condition,” she said.
According to Dr Hartini, up to 40% of AF patients may have what is known as “silent AF”, where the condition produces no noticeable symptoms.
“Without detection and treatment, these individuals remain at significant risk, with stroke sometimes being their first presentation,” she said.
Globally, AF is linked to between 20 and 30% of all ischaemic strokes, according to findings from the Framingham Study.
Health authorities, including the World Health Organisation and the European Society of Cardiology, recommend routine pulse checks as a simple first step in identifying potential cases.
A normal pulse should feel steady and regular, with a heart rate of between 60 and 100 beats per minute. Warning signs include an irregular rhythm, a fluttering sensation, or a heart rate that is unusually fast or slow.
Individuals who notice any of these symptoms should seek medical attention promptly. Diagnosis is typically confirmed through an electrocardiogram (ECG) or ambulatory heart monitoring.
Research has shown that routine pulse screening can help identify previously undiagnosed AF cases. The SAFE study found that pulse checks detected undiagnosed AF in approximately one to two per cent of older adults.
Once diagnosed, treatment can significantly reduce stroke risk. Oral anticoagulants, commonly known as blood thinners, remain the cornerstone of treatment and can lower stroke risk by up to 70%.
Newer direct oral anticoagulants offer additional benefits, including a 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 is more common among people aged 65 and above, Dr Hartini cautioned that younger individuals with hypertension, diabetes or existing heart conditions are also at risk.
She urged Malaysians to check their pulse regularly, manage chronic conditions such as high blood pressure and diabetes, maintain a healthy lifestyle and attend regular health screenings.
“A simple pulse check takes less than 30 seconds and could help detect a condition that significantly increases stroke risk,” she said. ‒ June 12, 2026
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