Atrial fibrillation AF

• Facts:
  Common complication of CABG
  Type of supraventricular tachyarrhythmia
• History / PE:
  Often asymptomatic
  Chest pain/palpitations
  Irregularly irregular pulse
  SOB
• Diagnosis:
  No P waves
  Variable and irregular QRS response
  Narrow QRS
  
• Treatment:
  1) Anticoagulation based on CHADS2 score ( greater than or equal to 3, then warfarin , less than 2, then ASA)
  2) Digoxin
  3) Cardioversion (if pt unstable)
  
• Pneumonic:
  Acute AF (PIRATES)
  
  P ulmonary disease
  I schemia
  R heumtic heart disease
  A nemia/A trial myxoma
  T hyrotoxicosis
  E thanol
  S epsis
  
• Notes:
  Digoxin (digitalis) used for both atrial fibrillation and atrial flutter
  
  CHADS2 scoring give 1 point for CHF, HTN, age >75, DM and two points for stroke or TIA
• Associated With:
  Mitral stenosis
  Hyperthyroidism
• Differential Diagnosis:
  Supraventricular tachyarrhythmia (SVT)