The Living Guidelines: Diagnosis and Management of Atrial Fibrillation

	Atrial Fibrillation Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Atrial Fibrillation from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Special Groups Postoperative AF Acute Myocardial Infarction Wolff-Parkinson-White Preexcitation Syndrome Hypertrophic Cardiomyopathy Hyperthyroidism Pulmonary Diseases Pregnancy ACS and/or PCI or valve intervention Heart failure
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram EKG Examples A-Fib with LBBB
Chest X Ray
Echocardiography
Holter Monitoring and Exercise Stress Testing
Cardiac MRI
Treatment
Rate and Rhythm Control
Cardioversion Overview Electrical Cardioversion Pharmacological Cardioversion
Anticoagulation Overview Warfarin Converting from or to Warfarin Converting from or to Parenteral Anticoagulants Dabigatran
Maintenance of Sinus Rhythm
Surgery Catheter Ablation AV Nodal Ablation Surgical Ablation Cardiac Surgery
Specific Patient Groups
Primary Prevention
Secondary Prevention
Supportive Trial Data
Cost-Effectiveness of Therapy
Case Studies
Case #1
The Living Guidelines: Diagnosis and Management of Atrial Fibrillation On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on The Living Guidelines: Diagnosis and Management of Atrial Fibrillation
CDC on The Living Guidelines: Diagnosis and Management of Atrial Fibrillation
The Living Guidelines: Diagnosis and Management of Atrial Fibrillation in the news
Blogs on The Living Guidelines: Diagnosis and Management of Atrial Fibrillation
Directions to Hospitals Treating The Living Guidelines: Diagnosis and Management of Atrial Fibrillation
Risk calculators and risk factors for The Living Guidelines: Diagnosis and Management of Atrial Fibrillation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Any recommendations found on these pages are for education use only. WikiDoc is not a substitute for a licensed healthcare provider. Please see the disclaimers page for important information regarding limitations of the information found here. In suggesting edits to the guidelines, WikiDoc suggests that the following classification scheme be used. Read more about the classification scheme used by the ACC / AHA Guidelines Committee here.

Recommendations for pharmacological rate control during atrial fibrillation ^[1]

Class I

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Atrial Fibrillation Microchapters
Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Atrial Fibrillation from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Special Groups Postoperative AF Acute Myocardial Infarction Wolff-Parkinson-White Preexcitation Syndrome Hypertrophic Cardiomyopathy Hyperthyroidism Pulmonary Diseases Pregnancy ACS and/or PCI or valve intervention Heart failure

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram EKG Examples A-Fib with LBBB

Chest X Ray

Echocardiography

Holter Monitoring and Exercise Stress Testing

Cardiac MRI

Treatment

Rate and Rhythm Control

Cardioversion Overview Electrical Cardioversion Pharmacological Cardioversion

Anticoagulation Overview Warfarin Converting from or to Warfarin Converting from or to Parenteral Anticoagulants Dabigatran

Maintenance of Sinus Rhythm

Surgery Catheter Ablation AV Nodal Ablation Surgical Ablation Cardiac Surgery
Specific Patient Groups

Primary Prevention
Secondary Prevention

Supportive Trial Data

Cost-Effectiveness of Therapy

Case Studies

Case #1

The Living Guidelines: Diagnosis and Management of Atrial Fibrillation On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on The Living Guidelines: Diagnosis and Management of Atrial Fibrillation

CDC on The Living Guidelines: Diagnosis and Management of Atrial Fibrillation

The Living Guidelines: Diagnosis and Management of Atrial Fibrillation in the news

Blogs on The Living Guidelines: Diagnosis and Management of Atrial Fibrillation

Directions to Hospitals Treating The Living Guidelines: Diagnosis and Management of Atrial Fibrillation

Risk calculators and risk factors for The Living Guidelines: Diagnosis and Management of Atrial Fibrillation

v t e Electrocardiography
Overview	History of the EKG • EKG interpretation basics • Normal sinus rhythm
EKG Complexes	P wave • QRS complex • ST Segment • T wave • T wave alternans • Tombstone T wave • U wave Osborn wave • H wave • K wave • Delta wave NSSTW changes
EKG Intervals	PR Interval • QRS Interval • ST Interval • QT Interval
Conduction System & Bradycardia	Cardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block
Atrial Arrhythmias	Sinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker
Ventricular Arrhythmias	Differential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death
EKG Abnormalities in Disease States	Hypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy • Acute myocardial infarction • NSTEMI • STEMI • Tombstone ST elevation • Right ventricular myocardial infarction • Atrial infarction Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins • Congenital heart block Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome Inherited Disease • Brugada Syndrome Systemic Diseases • CNS Disease • Cardiac Tumors Heart Transplantation • EKG Changes in patient with Heart Transplantation Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries
Technical Issues and Potential Errors in Interpretation	Artifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker • EKG in athletes

The Living Guidelines: Diagnosis and Management of Atrial Fibrillation

Recommendations for pharmacological rate control during atrial fibrillation [1]

Class I

Class IIa

Class IIb

Class III

Recommendations for preventing thromboembolism [1]

Class I

Class IIa

Class IIb

Class III

Recommendations for pharmacological cardioversion of atrial fibrillation [1]

Class I

Class IIa

Class IIb

Class III

Recommendation for direct-current cardioversion of atrial fibrillation and atrial flutter [1]

Class I

Class IIa

Class III

Recommendation for pharmacological enhancement of direct-current cardioversion [1]

Class IIa

Class IIb

Recommendation for prevention of thromboembolism in patients with atrial fibrillation undergoing cardioversion [1]

Class I

Class IIa

Recommendations for maintenance of sinus rhythm [1]

Class I

Class IIa

Class III

Recommendations for patients with postoperative atrial fibrillation [1]

Class I

Class IIa

Class IIb

Recommendations for patients with acute myocardial infarction [1]

Class I

Class IIa

Class III

Recommendations for patients with Wolff Parkinson White syndrome (WPW) [1]

Class I

Class IIa

Class IIb

Class III

Recommendations for patients with hyperthyroidism [1]

Class I

Recommendations for pregnant patients [1]

Class I

Class IIb

Recommendations for patients with Hypertrophic Cardiomyopathy [1]

Class I

Class IIa

Recommendations for patients with Pulmonary Hypertension [1]

Class I

Class III

References

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Recommendations for pharmacological rate control during atrial fibrillation ^[1]

Recommendations for preventing thromboembolism ^[1]

Recommendations for pharmacological cardioversion of atrial fibrillation ^[1]

Recommendation for direct-current cardioversion of atrial fibrillation and atrial flutter ^[1]

Recommendation for pharmacological enhancement of direct-current cardioversion ^[1]

Recommendation for prevention of thromboembolism in patients with atrial fibrillation undergoing cardioversion ^[1]

Recommendations for maintenance of sinus rhythm ^[1]

Recommendations for patients with postoperative atrial fibrillation ^[1]

Recommendations for patients with acute myocardial infarction ^[1]

Recommendations for patients with Wolff Parkinson White syndrome (WPW) ^[1]

Recommendations for patients with hyperthyroidism ^[1]

Recommendations for pregnant patients ^[1]

Recommendations for patients with Hypertrophic Cardiomyopathy ^[1]

Recommendations for patients with Pulmonary Hypertension ^[1]