Atrial fibrillation:
https://cks.nice.org.uk/topics/atrial-fibrillation/ [NICE guideline ref]
Definition: Is an arrhythmia. It results from irregular, disorganized electrical activity in the
atria, leading to an irregular ventricular rhythm. The ventricular rate of untreated AF often
averages between 160–180 beats per minute (although this is typically slower in older
people).
Symptoms:
• Breathlessness
• Light-headedness
• Fatigue
• Palpitations - describing their heart as racing, pounding or thumping in their chest
(may even feel this pounding in their throat)
• Chest pain
Diagnosis:
Need to assess for signs and symptoms to rule out undelying caused for AF
o Cardiac causes e.f HF, hypertension – use CHADVASK and HASBLED tool to
assess risks.
o Respiratory causes
o Systemic causes
Monitor blood pressure using microlife (oscillating BP monitor) detects pulse
irregularity caused by AF.
ECG
Echocardiogram-ultrasound of the heart
Thyroid function tests-because hyperthyroidism can lead to AF
Chest X-ray-show if HF associated with AF
Types of AF:
Paroxysmal
Spontaneously terminates within 7 days, but most often within 48 hours
Does not usually have to be treated with drugs
Persistent
Lasts longer than 7 days and is not self-terminating
Permanent
Longstanding AF (defined as more than a year) that can't be terminated with
cardioversion or has relapsed
Treatment: Management of AF involves controlling the rhythm or the rate of the heart (the
rate is safer to control). You can also use anti-coagulants to prevent strokes and treat any
underlying causes of the AF
Treat the arrythmia:
Rate control is first line strategy except in people:
• whose atrial fibrillation has a reversible cause.
https://cks.nice.org.uk/topics/atrial-fibrillation/ [NICE guideline ref]
Definition: Is an arrhythmia. It results from irregular, disorganized electrical activity in the
atria, leading to an irregular ventricular rhythm. The ventricular rate of untreated AF often
averages between 160–180 beats per minute (although this is typically slower in older
people).
Symptoms:
• Breathlessness
• Light-headedness
• Fatigue
• Palpitations - describing their heart as racing, pounding or thumping in their chest
(may even feel this pounding in their throat)
• Chest pain
Diagnosis:
Need to assess for signs and symptoms to rule out undelying caused for AF
o Cardiac causes e.f HF, hypertension – use CHADVASK and HASBLED tool to
assess risks.
o Respiratory causes
o Systemic causes
Monitor blood pressure using microlife (oscillating BP monitor) detects pulse
irregularity caused by AF.
ECG
Echocardiogram-ultrasound of the heart
Thyroid function tests-because hyperthyroidism can lead to AF
Chest X-ray-show if HF associated with AF
Types of AF:
Paroxysmal
Spontaneously terminates within 7 days, but most often within 48 hours
Does not usually have to be treated with drugs
Persistent
Lasts longer than 7 days and is not self-terminating
Permanent
Longstanding AF (defined as more than a year) that can't be terminated with
cardioversion or has relapsed
Treatment: Management of AF involves controlling the rhythm or the rate of the heart (the
rate is safer to control). You can also use anti-coagulants to prevent strokes and treat any
underlying causes of the AF
Treat the arrythmia:
Rate control is first line strategy except in people:
• whose atrial fibrillation has a reversible cause.
