Acute atrial fibrillation - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

New-onset atrial fibrillation (AF) is a new or first detectable episode of a chaotic and irregular atrial arrhythmia. Prevalence increases progressively with age.
AF causes significant morbidity and mortality including palpitations, dyspnea, angina, dizziness or syncope, and features of congestive heart failure, tachycardia-induced cardiomyopathy, stroke, and death.
ECG shows absent P waves, presence of fibrillatory waves, and irregularly irregular QRS complexes.
Most patients presenting with new-onset or "acute" atrial fibrillation (AF) do not require immediate cardioversion. Most patients will require medical therapy to control ventricular rate initially, and rhythm control subsequently.
Patients who develop hemodynamic compromise should have immediate direct current cardioversion.

Atrial fibrillation

From the collections of Arti N. Shah and Bharat K. Kantharia

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Multiple wavelets of atrial fibrillation compete with each other in the atrium and bombard the atrioventricular node with many signals.
Atrial fibrillation
Atrial flutter
Multifocal atrial tachycardia
Transesophageal echocardiogram showing left atrial appendage clot. LA=left atrium; LAA=left atrial appendage; LV=left ventricle
Atrial fibrillation
Atrial fibrillation with Wolff-Parkinson-White syndrome
CHA₂DS₂-VASc (congestive heart failure/left ventricular dysfunction, hypertension, age ≥75 years [doubled], diabetes, stroke [doubled], vascular disease, age 65-74 years, sex category [female])

Citations

Key Articles

Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2024 Jan 2;149(1):e1-156.[Abstract][Full Text]
Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498.[Full Text]

Other Online Resources

HEMORR2HAGES calculator
SAMe-TT₂R₂ score
CAEP: acute atrial fibrillation/flutter best practices checklist
WarfarinDosing.org

Referenced Articles

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