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Atrial FibrillationAka: Atrial Fib
- Epidemiology: Incidence
- Affects 1 million Americans
- Age 60 years: 1.5%
- Age 75 years: 9%
- Causes
- Atrial Fibrillation Causes
- History
- Onset of current episode of atrial fibrillation
- Frequency of atrial fibrillation
- First episode
- Paroxysmal
- Persistent or chronic
- Precipitating factors or triggers of current episode
- See Atrial Fibrillation Causes
- Exacerbation of chronic disease
- Coronary Artery Disease (CAD)
- Congestive Heart Failure (CHF)
- Chronic Obstructive Pulmonary Disease (COPD)
- Hypertension
- Thyroid Disorder
- Substances
- Alcohol Abuse
- Drug Abuse (Cocaine, Amphetamines)
- Caffeine
- Effective methods of terminating prior episodes
- Medications (e.g IV Diltiazem)
- Cardioversion
- Spontaneous resolution
- Symptoms (Often asymptomatic in young patients)
- Dyspnea
- Dizziness
- Palpitations
- Acute Fatigue
- Acute Congestive Heart Failure exacerbation
- Labs (esp. for initial episode)
- Chemistry panel with electrolytes and Renal Function
- Liver Function Tests (hepatic panel or LFTs)
- Thyroid Function Test (TSH with reflex to T4 free)
- Troponin I
- Brain Natriuretic Peptide (BNP)
- D-Dimer
- Diagnostics
- See Electrocardiogram in Atrial Fibrillation
- Review Blood Pressures
- Echocardiogram (TEE if early cardioversion pursued)
- Indicated in all patients with new onset
- Assess left and right atrial size
- Assess ejection fraction
- Assess Left Ventricular Hypertrophy
- Observe for valvular disease
- Assess for Pulmonary Hypertension (peak RV pressure)
- Consider stress testing
- Management
- See Atrial Fibrillation Acute Management
- See Atrial Fibrillation Anticoagulation
- See Atrial Fibrillation Cardioversion
- See Atrial Fibrillation Rate Control
- Complications
- Congestive Heart Failure
- Myocardial Infarction
- Thromboembolism
- Prognosis
- Mortality: increased two fold over general population
- References
- King (2002) Am Fam Physician 66(2):249
Atrial Fibrillation (C0004238)
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| Definition (MSH) | Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation. |
| Definition (CSP) | disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. |
| Definition (NCI) | An arrhythmia in which minute areas of the atrial myocardium are in various uncoordinated stages of depolarization and repolarization; instead of intermittently contracting, the atria quiver continuously in a chaotic pattern, causing a totally irregular, often rapid ventricular rate. |
| Definition (NCI) | A supraventricular arrhythmia characterized by uncoordinated atrial myocardium activation due to multiple reentry circuits with consequent deterioration of atrial mechanical function. Instead of intermittently contracting, the atria quiver continuously in a chaotic pattern, causing a totally irregular, often tachycardia ventricular rate. On the ECG it is described by the replacement of consistent P waves by rapid oscillations or fibrillatory waves that vary in size, shape, and timing, associated with an irregular, frequently rapid ventricular response when atrioventricular conduction is intact. |
| Concepts | Pathologic Function (T046)
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| ICD9 | 427.31 |
| English | AF, AFib, Atrial Fibrillation, Atrial Fibrillations, Auricular Fibrillation, Auricular Fibrillations, FIBRILLATION ATRIAL |
| Spanish | fibrilación auricular, fibrilacion auricular |
| Credits | Derived from the NIH UMLS (Unified Medical Language System)
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