Atrial Fibrillation

Atrial fibrillation (AF) is the most common type of abnormal heartbeat. Although often not considered life-threatening itself, AF should be taken seriously because it can lead to more serious conditions such as other heart rhythm disorders, chronic fatigue syndrome, stroke, and congestive heart failure. At Pacific Rim Electrophysiology based in Bangkok, Thailand, we understand how important it is to manage your atrial fibrillation. We are international leaders in the diagnosis and treatment of AF and other cardiac arrhythmias.

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For more information, request a consultation at the office of Pacific Rim Electrophysiology using our online form. Recognized as international leaders in arrhythmia treatment and research, we serve patients from around the world.

Los Angeles Cardiologist Dr. Nademanee

Meet Doctor Nademanee

An innovator of advanced cardiac arrhythmia treatments that have attracted the attention of specialists and patients worldwide.

What Is Atrial Fibrillation?

Atrial fibrillation originates in various areas of the 2 upper chambers of the heart (the atria). Instead of beating in a productive, regular rhythm, a heart in AF beats very rapidly, irregularly, and ineffectively. During episodes of AF, the blood is not pumped out of the heart completely and the body can become starved of oxygen. Also, the blood that remains in the heart can pool and forms clots, which may travel into the circulatory system and cause a stroke.

Atrial Fibrillation Symptoms

Atrial fibrillation can occur periodically (paroxysmal) or continuously (chronic). The symptoms vary between individuals and can sometimes be subtle and barely noticeable. But for many people the symptoms of AF are obvious, uncomfortable, and even frightening. These symptoms can include a combination of the following sensations:

  • Sudden flutter or tremor of the heart
  • Skipped heartbeats that are followed by a thud and acceleration of the heart
  • Rapid heartbeat
  • Chest and throat pressure or pain
  • Weakness and difficulty exercising, such as when walking or climbing stairs
  • Sweating, dizziness, shortness of breath, or fainting (syncope)

It’s important to consult with your doctor if you experience any of these symptoms to determine if you have AF and whether you require treatment.

Causes of Atrial Fibrillation

There is a wide range of causes for the abnormal electrical signals of AF including:

  • Heart disease, such as cardiomyopathy, coronary artery disease, valvular heart disease, and ventricular hypertrophy
  • Medical conditions such as high blood pressure, hyperthyroidism, diabetes, and clogged arteries (atherosclerosis)
  • Heart surgery, including valve surgery and coronary artery bypass
  • Stress, fatigue, and excessive alcohol, caffeine, or nicotine consumption
  • Obstructive sleep apnea

It is possible to have AF without heart disease, an associated condition, or otherwise obvious cause, especially in younger patients. In this case the condition is called lone atrial fibrillation.


Catheter ablation is an effective method for cardiac arrhythmias, including AF. Our director, Dr. Koonlawee Nademanee, pioneered a cutting edge approach to catheter ablation that targets specific sites in the heart using a 3-dimensional mapping of complex fractionated atrial electrograms (CFAEs). We have successfully resolved the majority of AFs through CFAE ablation. If the arrhythmia is not completely resolved, we perform standard AF ablation. This protocol provides our patients with lasting results and quicker recovery than with the standard practice of performing AF ablation first.

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