Atrial Fibrillation
Key words: AF, arrhythmia, stroke, thromboembolism, anticoagulation, warfarin
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is a leading cause of stroke, especially in the elderly.
Atrial fibrillation is a supraventricular tachyarrhythmia characterised by disorganised atrial electrical activity and progressive deterioration of atrial electromechanical function.
The ECG demonstrates absent p waves, chaotic atrial activity and an irregular ventricular response. Prevalence of atrial fibrillation increases dramatically with age.
Patients may experience a wide range of symptoms, including palpitations, dyspnoea, fatigue, dizziness, angina and decompensated heart failure, although some will be asymptomatic.
Cardiac Failure
Treatment guidelines include measures to slow the ventricular rate, electrically revert and anticoagulate to reduce the risk of stroke.
Procedures
Cardioversion procedure External direct current cardioversion (DCC) is the application of a brief pulse of direct electrical current across the chest wall of a patient with an appropriate rapid dysrhythmia, causing momentary depolarization of most cardiac cells…
Guidelines and clinical resources
- Clinical update on atrial fibrillation from the Medical Journal of Australia (2007) Deciding between a rate control or rhythm control approach depends on patient age and comorbidities, symptoms and haemodynamic consequences of the arrhythmia, but either approach is acceptable…
- Guidelines for the Management of Patients with Atrial Fibrillation from the American College of Cardiology, American Heart Association and the European Society of Cardiology (2006) These guidelines first present a comprehensive review of the latest information about the definition, classification, epidemiology, pathophysiological mechanisms, and clinical characteristics of AF…
- Warfarin reversal guidelines from the Australian Warfarin Consensus Group (2004) Anticoagulation is very effective for primary and secondary prevention of thromboembolic events. However, questions persist about the risks and management of over-anticoagulation…
- Warfarin: balancing the benefits and harms , Australian Prescriber (2004) The benefits of warfarin therapy are substantial in the prevention of arterial and venous thrombosis, and in the primary and secondary prevention of stroke related to non-rheumatic atrial fibrillation. The major risk of warfarin is bleeding, which can cause significant morbidity or mortality…
- MD Consult AF Article covering diagnosis, treatment, outcomes and prevention in atrial fibrillation Atrial fibrillation is the most common type of cardiac arrhythmia, defined by irregular ventricular pulse and apical-radial mismatch…
- Emedicine overview of AF covering differential diagnoses, treatment, follow-up and pathophysiology of atrial fibrillation Atrial fibrillation is the most common arrhythmia encountered in clinical practice and is a significant public health problem…
Images
Atrial fibrillation with slow ventricular response
Electrocardiogram (ECG) of Atrial fibrillation with slow ventricular response
Atrial fibrillation with rapid ventricular response
Electrocardiogram (ECG) of Atrial fibrillation with rapid ventricular response
Atrial Flutter with variable block
Electrocardiogram (ECG) of Atrial Flutter with variable block
