With his father dying and his heart racing, Andrew thought his months-long physical response was a symptom of grief.
But when the 59-year-old business owner's symptoms worsened on the night of his father's funeral, he went to hospital, where doctors discovered his heart was beating at 149 beats per minute for eight hours.
"Normally, my racing heart lasts two to three minutes and then stops, but on this occasion, it felt different," Andrew said.
After undergoing tests he was discharged, but the next day woke up feeling very unwell.
"My heart was still racing, and I felt very sick, so I returned to hospital. (The doctors) suspected atrial fibrillation, but I was not given a formal diagnosis," Andrew said.
More than half a million Australians have atrial fibrillation – a lifelong, progressive disease where faulty electrical signals of the heart cause the top chambers known as the atria, to beat faster or erratically.
Other AF symptoms include chest tightness, fatigue, shortness of breath and dizziness.
New research shows that more than one-in-three Australians aged 50 and over who have an irregular heartbeat are experiencing four or more symptoms before visiting a doctor.
Over the next three years, Andrew experienced no major symptoms, until 2023, when the grief of losing his aunt triggered another AF episode.
"I saw my cardiologist and was formally diagnosed with AF. My heart palpitations returned, triggered by this big, emotional event," he said.
Andrew's diagnosis had a significant impact on him and his family and it left him feeling "confused, anxious and out of control".
He received treatment and in October 2023, underwent a cardiac ablation, a procedure to stop arrhythmias.
"I now have more energy; I can run more. Living with AF was like I was unknowingly carrying a backpack; everything was harder," Andrew said.
Cardiologist and electrophysiologist Tomos Walters said the burden and prevalence of AF was often underestimated because 30-40 per cent of patients might not display visible symptoms, which makes diagnosis challenging.
"The underestimation of disease prevalence, combined with low community awareness … is creating the perfect storm for one of the largest, and most pressing public health epidemics," Dr Walters said.
AF cases in those aged 55 and above are projected to double over the next two decades, driven by the ageing population and rising rates of excess weight and obesity.
The research, commissioned by Boston Scientific, involved an online survey of 1015 Australians.
