Screening and diagnosis of
atrial fibrillation

Screening for atrial fibrillation, also known as AF and Afib, is often conducted in people who are aged 65 years or more, and/or who have risk factors for developing AF, as part of a routine medical check-up.1

Usually, the first step when screening for AF is to check your pulse (pulse palpation) – your doctor may do that at your appointment, or they may ask you to take your pulse at home. However, a full medical investigation, including an electrocardiogram – also known as an ECG – will be needed before a diagnosis of AF can be made.1-4

Watch a short animation on how to keep an eye on your heart rate by checking your pulse

Checking your pulse may give a good indication of whether you have AF

Your pulse, usually called your heart rate, is the number of times that your heart beats each minute.5 Checking your pulse helps to tell you and your doctor your heart rate.

A normal baseline, also known as your resting heart rate, should beat evenly, like the ticking of a clock, with 60 to 100 beats per minute.6 In AF, the heart rate can often be considerably higher than 100 beats per minute, and each individual beat is erratic.4

As your heart rate changes throughout the day and depends on your physical activities, to get your resting heart rate you should check your pulse first thing in the morning, before you get out of bed.5,6

Click image to download a quick guide to checking your pulse

To check your pulse, follow the steps below:4,6

  • Sit down for 5 minutes, remove any watches or jewellery, and relax – do not smoke or have caffeine before taking the reading, as this can increase your heart rate
  • Place your hand down with your palm facing upwards and elbow slightly bent
  • Take the index and middle fingers of your other hand, and press firmly on your wrist near the base of the thumb
  • Press firmly, keeping pressure on your wrist, and count your heartbeats for 30 seconds
  • Multiply the number of beats by two to get the beats per minute

If your pulse feels irregular, fluttery, or accelerated, keep monitoring it for a full minute and do not multiply the number of beats.6

The easiest place to take your pulse is on your wrist. However, you can also feel it in the crease of your elbow, in your groin, or even behind your knee.6

If you ever notice anything unusual when you are taking your pulse, or if you need help learning how to check your pulse, you should visit your doctor.4,6

If you have chest pain, it is important that you see your doctor as soon as possible.4

1.Heart Foundation. Clinical fact sheet: atrial fibrillation screening and diagnosis work up. February 2019. Available at Last accessed November 2020.

2. NICE NG196. Atrial fibrillation: diagnosis and management. 2021. Available at Last accessed May 2021.

3. Taggar JS et al. Eur J Prev Cardiol 2016; 23: 1330-1338.

4. NHS. Diagnosis – atrial fibrillation. April 2018. Available at Last accessed November 2020.

5. PeaceHealth. Pulse Measurement – Test overview. March 2019. Available at Last accessed November 2020.

6. Arrhythmia Alliance. Know Your Pulse Factsheet. April 2009; reviewed January 2017. Available at Last accessed November 2020.

7. NHS. Electrocardiogram (ECG). June 2018. Available at Last accessed November 2020.

8 PMS Instruments. Why You Should Use ECG Event Recorders in Primary Care. October 2014. Available at Last accessed November 2020.

9. WebMD. How Atrial Fibrillation Is Diagnosed. May 2018. Available at Last accessed November 2020.

10. British Heart Foundation. ECG. Available at Last accessed November 2020.

11. Galli A, et al. Arrhythm Electrophysiol 2016; 5: 136-143.

12. ECG event recorder (R test). Royal Brompton & Harefield NHS Foundation Trust. Available at Last accessed November 2020.

PP-ELI-HKG-0643 JUN 2021