Atrial Fibrillation

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EKG Characteristics

Atrial Fibrillation is a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation with consequent deterioration of atrial mechanical function. On the electrocardiogram (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 (AV) conduction is intact


Atrial fibrillation is the most common sustained arrhythmia seen in clinical practice with an estimated 2 million patients with atrial fibrillation in the United States. The prevalence and incidence of atrial fibrillation increase with advancing age. The mainstay of therapy includes pharmacologic rate control, antiarrhythmic therapy, cardioversion, and anti-thromboembolic management. Non-pharmacologic therapies, include ablation with a Pulmonary Vein Isolation, Surgical PVI or Maze Procedure.

Prevalence of Atrial Fibrillation

  • 0.4% general population
  • 0.2% in population 25-34 yrs old
  • 2-5% in population >60 yrs old
  • 10% in population > 80 yrs old
  • 8-14% in hospitalized patients

Incidence of Atrial Fibrillation

  • 0.1%/year (>160,000 new U.S. cases/yr)
  • 20-40% after cardiac surgery

Causes of Atrial Fibrillation


  • Bellet S. Clinical Disorders of the Heart Beat. 3rd ed. Philadelphia: Lea & Febiger, 1971.
  • ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology
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