Atrial Fibrillation

Clinical Manifestations
1. Symptoms (Jankowska-Polańska, Kaczan, Lomper, Nowakowski, & Dudek, 2018).
  1. Psychological distress
    1. Those with atrial fibrillation have a high prevalence of anxiety and depression caused by the symptoms they experience thus resulting in a decreased quality of life (Gehi et al., 2012).
  2. Shortness of breath
  3. Atrial Fibrillation may be asymptomatic in some patients (Medical Advisory Secretariat, 2006)
  4. Weakness
  5. Heart palpitations
  6. Chest pain
  7. Sleep difficulties
  8. Exercise intolerance (McCabe, Rhudy, Chamberlain, & DeVon, 2016).
2. Signs (Natale & Jalife, 2008).
  1. Tachycardia
  2. Reduced cardiac output
    1. Symptoms include decreased limp temperature, increased core temperature, decreased urine output, and mottled skin colour (Cuadrado, 2002).
  3. Radial pulse is lower than apical pulse (Lippincott, 2011).
  4. Abnormal ECG findings (Lippincott, 2011)
    1. Atrial activity is no longer represented by P waves but by fibrillatory waves (f waves). This rhythm may be either sustained or paroxysmal (occurring in bursts).
    2. Irregular pulse rhythm
    3. Undetectable atrial heart rate
    4. Ventricular heart rate around 130 beats per minute
    5. PQR - undetectable
    6. T wave - undetectable
    7. QT - unmeasurable
    8. QRS complex - 0.08 second
    9. The first figure shows a healthy ECG record. The second figure shows an ECG with atrial fibrillation (Queiroz, Junior, Lucena, & Barros, 2018).
Diagnostic Testing
Complications
1. Patients with may also experience increased morbidity and mortality from complications such as heart failure, strokes, hemorrhagic and thromboembolic complications, heart attacks and cardiovascular death (Jankowska-Polańska, Kaczan, Lomper, Nowakowski, & Dudek, 2018; Mogensen et al., 2017).
  1. Roughly 44% of those with one of the three types of atrial fibrillation had a stroke.
  2. Approximately 43% of those with any of the types of atrial fibrillation have been hospitalized for heart failure at some point.
  3. Around 69% of the deaths of those with atrial fibrillation was due to a heart attack or other sudden cardiovascular event.
Classifications/Variations
Treatment and Management
1. Cardiac Ablation (Medical Advisory Secretariat, 2006).
  1. Cardiac ablation involves using a probe with an electrode at the tip on cardiac tissue with the goal of scarring the area to prevent an electrical current from being conducted through the area.
    1. Types
      1. Segmental Pulmonary Vein Ablation: the pulmonary vein is isolated from the left atrium by applying lesions at the ostial region of the pulmonary veins.
      2. Circumferential pulmonary vein ablation: surrounds the pulmonary veins in linear lesions on the left atrial myocardium outside the pulmonary vein ostia.
    2. Catheter ablation is the procedure in which cardiac ablation is performed. It involves precisely inserting a catheter through the femoral vein to access the heart in order to perform the ablation procedure
2. Pharmacotherapy
  1. Heart Rate Control. In order for heart rate to be considered controlled it must meet three goals: controlled at rest, controlled during activity, and regularization of the heart rate (Natale & Jalife, 2008).
    1. Diltiazem or verapamil should be used as the preferred method over digoxin when using pharmacotherapy in controlling heart rate as it has a better effect on the control of heart rate during activity. Diltiazem or verapamil both have a rapid onset of action; this is especially important in acute situations. β-blockers are the best at controlling heart rate with activity. Atenolol, metoprolol, pindolol, and nadolol are all effective at controlling heart rates at rest and with exertion.
  2. Pharmacological Cardioversion
Etiology

Nächster

Atrial Fibrillation

Beschreibung

Zusammenfassung der Ressource

Medienanhänge

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