II. Diagnostics: Electrocardiogram
- No history of AV nodal blocking drugs
- No discrete atrial activity
- Discrete P Waves absent
- Atrial Fibrillation waves (F Waves) seen
- Rapid oscillations or fibrillatory waves
- Small irregular waves at rate of 150-300 bpm
- Difficult to detect at high atrial rates (fine)
- Ventricular response
- Rapid rate up to 160-200 bpm
- Irregularly irregular rhythm
- Inconsistent R-R interval
- Variants
- Irregular Wide Complex Tachycardia
- Suggests Atrial Fibrillation with aberrant conduction (Ashman Phenomenon)
- Heart Rate faster than 200/min
- Accessory pathway (e.g. Atrial Fibrillation with Wolff-Parkinson-White or WPW)
- Irregular Wide Complex Tachycardia
III. Differential Diagnosis: Atrial Fibrillation Causes
- Acute coronary ischemia
- Left QRS Axis
- Left P Wave Axis
- Acute Pulmonary Disease
- Mitral Stenosis
- Lone Atrial Fibrillation
- Normal or Left QRS Axis
- Normal or Left P Wave Axis
- Thyrotoxicosis
- Holiday Heart
-
Atrial Flutter
- Prominent saw tooth waves
- Atrial rate slower than Atrial Fibrillation
IV. References
- Casaletto (2014) Crit Dec Emerg Med 28(4): 10-19
- Stiell (2011) Canadian J Cardiol 27(1): 38-46 [PubMed]
- Wann (2011) Circulation 123(1): 104-23 [PubMed]
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Related Studies
| Definition (CHV) | rapid tremor and shake of upper chambers of the heart |
| Definition (CHV) | rapid tremor and shake of upper chambers of the heart |
| Definition (CHV) | rapid tremor and shake of upper chambers of the heart |
| Definition (CHV) | rapid tremor and shake of upper chambers of the heart |
| Definition (CHV) | rapid tremor and shake of upper chambers of the heart |
| Definition (CHV) | rapid tremor and shake of upper chambers of the heart |
| Definition (MEDLINEPLUS) |
An arrhythmia is a problem with the speed or rhythm of the heartbeat. Atrial fibrillation (AF) is the most common type of arrhythmia. The cause is a disorder in the heart's electrical system. Often, people who have AF may not even feel symptoms. But you may feel
AF can lead to an increased risk of stroke. In many patients, it can also cause chest pain, heart attack, or heart failure. Doctors diagnose AF using family and medical history, a physical exam, and a test called an electrocardiogram (EKG), which looks at the electrical waves your heart makes. Treatments include medicines and procedures to restore normal rhythm. NIH: National Heart, Lung, and Blood Institute |
| Definition (NCI_CTCAE) | A disorder characterized by a dysrhythmia without discernible P waves and an irregular ventricular response due to multiple reentry circuits. The rhythm disturbance originates above the ventricles. |
| Definition (NCI_FDA) | An arrhythmia in which minute areas of the atrial myocardium are in various uncoordinated stages of depolarization and repolarization; instead of intermittently contracting, the atria quiver continuously in a chaotic pattern, causing a totally irregular, often rapid ventricular rate. |
| Definition (NCI) | A disorder characterized by an electrocardiographic finding of a supraventricular arrhythmia characterized by the replacement of consistent P waves by rapid oscillations or fibrillatory waves that vary in size, shape and timing and are accompanied by an irregular ventricular response. (CDISC) |
| Definition (CSP) | disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. |
| Definition (MSH) | Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation. |
| Concepts | Pathologic Function (T046) |
| MSH | D001281 |
| ICD9 | 427.31 |
| SnomedCT | 155364009, 266306001, 49436004 |
| LNC | LA17084-7 |
| English | Atrial Fibrillations, Auricular Fibrillation, Auricular Fibrillations, Fibrillations, Atrial, Fibrillations, Auricular, FIBRILLATION ATRIAL, AURICULAR FIBRILLATION, Auricular fibrillation, Fibrillation, Atrial, Fibrillation, Auricular, AF, atrial fibrillation, atrial fibrillation (diagnosis), Afib, AFib, Fibrillation atrial, Atrial Fibrillation [Disease/Finding], Fibrillation;atrial, afib, atrial fibrillation (AF), auricular fibrillations, atrial fibrillations, Familial Atrial Fibrillation, Fibrillation - atrial, ATRIAL FIBRILLATION, Atrial fibrillation, AF - Atrial fibrillation, Atrial fibrillation (disorder), atrium; fibrillation, auricular; fibrillation, fibrillation; atrial or auricular, Atrial Fibrillation, auricular fibrillation |
| French | FIBRILLATION AURICULAIRE, FA, AFib, Fibrillation auriculaire, Fibrillation atriale |
| German | VORHOFFLIMMERN, AF, Afib, Flimmern Vorhof, Herzohrflimmern, HERZVORHOFFLIMMERN, Vorhofflimmern, Aurikuläres Flimmern |
| Portuguese | FIBRILACAO AURICULAR, FA, FIBRILHACAO AURICULAR, Fibrilhação auricular, Fibrilação Atrial, Fibrilação Auricular |
| Spanish | FIBRILACION AURICULAR, FA, Fibrilación atrial, AURICULAR, FIBRILACION, fibrilación auricular (trastorno), fibrilación auricular, Fibrilación auricular, Fibrilación Atrial, Fibrilación Auricular |
| Dutch | AFib, AF, atriumfibrillatie, hartoorfibrilleren, atrium; fibrilleren, auriculair; fibrilleren, fibrilleren; atrium of auriculair, atriale fibrillatie, Atriumfibrillatie, Boezemfibrillatie, Fibrillatie, atrium-, Fibrillatie, boezem-, Fibrilleren, boezem- |
| Swedish | Förmaksflimmer |
| Japanese | ｼﾝﾎﾞｳｻｲﾄﾞｳ, 心房細動, 心房性細動 |
| Finnish | Eteisvärinä |
| Russian | USHKA PREDSERDIIA FIBRILLIATSIIA, PREDSERDII FIBRILLIATSIIA, ПРЕДСЕРДИЙ ФИБРИЛЛЯЦИЯ, УШКА ПРЕДСЕРДИЯ ФИБРИЛЛЯЦИЯ |
| Czech | Fibrilace ouška, Fibrilace síní, fibrilace síní, síňová fibrilace, FiS |
| Italian | Fibrillazione auricolare, Fibrillazione atriale |
| Croatian | ATRIJ, FIBRILACIJA |
| Polish | Migotanie przedsionków |
| Hungarian | AFib, Fibrillatio atrialis, Pitvarfibrillatio |
| Norwegian | Forkammerflimmer, Hjerteflimmer, Artrieflimmer |
