Atrial fibrillation causes: Difference between revisions

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{| class="infobox" style="float:right;"
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| [[File:Siren.gif|30px|link=Atrial fibrillation resident survival guide]]|| <br> || <br>
| [[Atrial fibrillation resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
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{| class="infobox" style="float:right;"
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| [[File:Critical_pathways_.gif|88px|link=Atrial fibrillation critical pathways]]|| <br> || <br>
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{{Atrial fibrillation}}
{{Atrial fibrillation}}
{{CMG}}
{{CMG}}; {{AE}} {{Hilda}} {{Ochuko}}


==Overview==
==Overview==
The most common cause of atrial fibrillation is atrial dilation associated with [[hypertension]]. Approximately 1/3 of patients have [[familial atrial fibrillation]] which is due to an underlying [[genetic disorder]].  Given the number of patients who undergo [[coronary artery bypass grafting]] in the developed world, this is an increasing underlying cause of atrial fibrillation. Other general causes include the advancing age of the population this hemodynamic stress of [[heart failure]] and [[valvular heart disease]], [[myocardial ischemia]], a variety of inflammatory disorders, [[pulmonary disease]]s, [[alcohol]] and [[drug abuse]], and [[endocrine disorder]]s.
The most common cause of atrial fibrillation is [[atrium|atrial]] dilation associated with [[hypertension]]. [[Atrial fibrillation]] can be caused by several organic [[heart|cardiac]] [[diseases]], but it has also been reported to have a [[familial]] [[etiology]] in some [[patients]]. Approximately 1/3 of [[patients]] have [[familial atrial fibrillation]] which is due to an underlying [[genetic disorder]].  In developed countries, [[hypertensive heart disease]] and [[coronary heart disease]] are the two most common causes of [[atrial fibrillation]]. However, [[rheumatic heart disease]] is associated with a higher incidence of [[atrial fibrillation]] in developing countries. Life threatening conditions such as [[acute coronary syndromes]], [[electrolyte imbalance]], [[dehydration]], [[hypoxia]], [[pulmonary embolism]], [[myocarditis]] and [[pericarditis]] should be identified and promptly treated. Other general causes such as the advancing [[Ageing|age]] of the population, the [[Hemodynamics|hemodynamic stress]] of [[heart failure]] and [[valvular heart disease]], [[myocardial ischemia]], a variety of [[inflammation|inflammatory disorders]], [[lung|pulmonary]] [[diseases]], [[alcohol]], [[drug abuse]], and [[endocrine]] disorders.


==Causes==
==Causes==
===Life Threatening Causes===
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. The following are some of the well known life threatening causes of [[atrial fibrillation]]:<ref name="Fox-2004">{{Cite journal  | last1 = Fox | first1 = CS. | last2 = Parise | first2 = H. | last3 = D'Agostino | first3 = RB. | last4 = Lloyd-Jones | first4 = DM. | last5 = Vasan | first5 = RS. | last6 = Wang | first6 = TJ. | last7 = Levy | first7 = D. | last8 = Wolf | first8 = PA. | last9 = Benjamin | first9 = EJ. | title = Parental atrial fibrillation as a risk factor for atrial fibrillation in offspring. | journal = JAMA | volume = 291 | issue = 23 | pages = 2851-5 | month = Jun | year = 2004 | doi = 10.1001/jama.291.23.2851 | PMID = 15199036 }}</ref><ref name="Zimetbaum-2000">{{Cite journal  | last1 = Zimetbaum | first1 = PJ. | last2 = Josephson | first2 = ME. | last3 = McDonald | first3 = MJ. | last4 = McClennen | first4 = S. | last5 = Korley | first5 = V. | last6 = Ho | first6 = KK. | last7 = Papageorgiou | first7 = P. | last8 = Cohen | first8 = DJ. | title = Incidence and predictors of myocardial infarction among patients with atrial fibrillation. | journal = J Am Coll Cardiol | volume = 36 | issue = 4 | pages = 1223-7 | month = Oct | year = 2000 | doi =  | PMID = 11028474 }}</ref><ref name="Goldhaber-1999">{{Cite journal  | last1 = Goldhaber | first1 = SZ. | last2 = Visani | first2 = L. | last3 = De Rosa | first3 = M. | title = Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER) | journal = Lancet | volume = 353 | issue = 9162 | pages = 1386-9 | month = Apr | year = 1999 | doi =  | PMID = 10227218 }}</ref>
*[[Congestive heart failure]]
*[[Dehydration]]
*[[Electrolyte disturbance]]
*[[Hypothermia]]
*[[Hypoxia]]
*[[Myocardial infarction]]
*[[Myocarditis]]
*[[Pericarditis]]
*[[Pulmonary embolism]]
*[[Uremic pericarditis]]
===Common Causes===
===Common Causes===
* [[COPD]]
The following are the common causes of [[atrial fibrillation]]:<ref name="Krahn-1995">{{Cite journal  | last1 = Krahn | first1 = AD. | last2 = Manfreda | first2 = J. | last3 = Tate | first3 = RB. | last4 = Mathewson | first4 = FA. | last5 = Cuddy | first5 = TE. | title = The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. | journal = Am J Med | volume = 98 | issue = 5 | pages = 476-84 | month = May | year = 1995 | doi = 10.1016/S0002-9343(99)80348-9 | PMID = 7733127 }}</ref><ref name="Kannel-1982">{{Cite journal  | last1 = Kannel | first1 = WB. | last2 = Abbott | first2 = RD. | last3 = Savage | first3 = DD. | last4 = McNamara | first4 = PM. | title = Epidemiologic features of chronic atrial fibrillation: the Framingham study. | journal = N Engl J Med | volume = 306 | issue = 17 | pages = 1018-22 | month = Apr | year = 1982 | doi = 10.1056/NEJM198204293061703 | PMID = 7062992 }}</ref><ref name="Grigioni-2002">{{Cite journal  | last1 = Grigioni | first1 = F. | last2 = Avierinos | first2 = JF. | last3 = Ling | first3 = LH. | last4 = Scott | first4 = CG. | last5 = Bailey | first5 = KR. | last6 = Tajik | first6 = AJ. | last7 = Frye | first7 = RL. | last8 = Enriquez-Sarano | first8 = M. | title = Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome. | journal = J Am Coll Cardiol | volume = 40 | issue = 1 | pages = 84-92 | month = Jul | year = 2002 | doi =  | PMID = 12103260 }}</ref>
* [[Drugs]]
*[[Coronary artery disease]]
* [[Hypertension]]
*[[Hypertensive heart disease]]
* [[MI]]
*[[Rheumatic heart disease]]
* [[Sick sinus syndrome]]
* [[Sleep apnea]]
* [[Stress]]
* [[Thyrotoxicosis]]
* [[Valvular heart disease]]
 
===Causes by Organ System===
===Causes by Organ System===
 
{|style="width:80%; height:100px" border="1"
{|style="width:70%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | Atrial ischemia or [[atrial infarction]], [[Atrial myxoma]], [[Atrial septal defect]], [[Cardiac tumors]], [[Cardiomyopathy]], [[Channelopaties]] particularly abnormalities in the sodium channels, [[Congestive heart failure]], [[Constrictive pericarditis]], [[Coronary Artery Bypass Graft Surgery]], [[Coronary Artery Disease]], [[Dilated cardiomyopathy]], [[Endocarditis]], [[Familial atrial fibrillation type 1]], [[Familial atrial fibrillation type 3]], [[HOCM]], [[Hypertension]], [[Left ventricular hypertrophy]], [[Lutembacher's syndrome]], [[Mitral regurgitation]], [[Mitral stenosis]], [[Myocardial infarction]], [[Myocarditis]], [[Pericarditis]], [[Rheumatic fever]], [[ST elevation myocardial infarction]] ([[STEMI]]), [[Tricuspid regurgitation]], [[Tricuspid stenosis]], [[Unstable angina]], [[Valvular heart disease]]
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Alcoholic cardiomyopathy]], [[atrial infarction|Atrial ischemia]], [[atrial myxoma]], [[atrial septal defect]], [[cardiac surgery]], [[cardiac tumors]], [[cardiomyopathy]], [[conduction disorders]], [[congenital heart disease]], [[congestive heart failure]], [[constrictive  pericarditis]], [[coronary artery bypass graft  surgery]], [[coronary artery disease]], [[dilated cardiomyopathy]], [[endocarditis]], [[Eisenmenger syndrome]], [[endomyocardial fibrosis]], [[familial atrial fibrillation]], [[hypertensive heart disease]], [[hypertrophic  cardiomyopathy]], [[ischemic heart disease]], [[Lutembacher syndrome]], [[mitral regurgitation]], [[mitral stenosis]], [[myocardial infarction]], [[myocarditis]], [[atrioventricular block|partial atrioventricular block]], [[pericarditis]], [[peripartum  cardiomyopathy]], [[pulmonary embolism]], [[pulmonary hypertension]], [[short QT syndrome]], [[sick sinus syndrome]], [[sinoatrial block]], [[systemic hypertension]], [[tricuspid regurgitation]], [[tricuspid stenosis]], [[unstable angina]], [[uremic pericarditis]], [[valvular heart disease]], [[Wolff-Parkinson-White syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Alcohol]], [[Alcohol withdrawal]], Breath spray which contains alcohol, <ref name="pmid2914028">{{cite journal| author=Ridker PM, Gibson CM, Lopez R| title=Atrial fibrillation induced by breath spray. | journal=N Engl J Med | year= 1989 | volume= 320 | issue= 2 | pages= 124 | pmid=2914028 | doi= | pmc= | url= }} </ref> [[Caffeine]],
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Alcohol]], [[Alcohol withdrawal]], [[Cocaine]], [[Conivaptan]], [[Methamphetamine]]s, [[Porfimer sodium]], Tea
|bgcolor="Beige"| [[Amphetamine]], [[caspofungin acetate]], [[conivaptan]], [[cyclophosphamide]], [[ciclosporin|cyclosporine toxicity]], [[etravirine]], [[febuxostat]], [[felbamate]], [[granisetron]], [[guanidine]], [[ibrutinib]], [[idarubicin hydrochloride]], [[ioxilan]], [[interleukin 2]], [[lacosamide]], [[metipranolol]], [[niacin]], [[oprelvekin]], [[pergolide]], [[porfimer sodium]], [[pramipexole]], [[ropinirole]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| [[Hyperthyroidism]], [[Hypothyroidism]], [[Pheochromocytoma]]
|bgcolor="Beige"| [[Diabetes]], [[Graves disease]], [[hyperthyroidism]], [[hypothyroidism]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| [[Hypothermia]]
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| Esophageal surgery
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| [[Atherosclerosis]], [[Channelopaties]] particularly abnormalities in the sodium channels, [[Familial atrial fibrillation type 1]], [[Familial atrial fibrillation type 3]], [[HOCM]]
|bgcolor="Beige"| [[Familial atrial fibrillation]], [[hemochromatosis]], [[McLeod syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Hemochromatosis]], [[McLeod syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| Esophageal surgery
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Endocarditis]], [[Myocarditis]], [[Pericarditis]], [[Pneumonia]], [[Rheumatic fever]]
|bgcolor="Beige"| [[Viral  infections]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Collagen vascular disease]]
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"| [[Stroke]], [[Subarachnoid hemorrhage]]
|bgcolor="Beige"| [[Stroke]], [[subarachnoid  hemorrhage]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Diabetes]], [[Hypothyroidism]], [[Obesity]]
|bgcolor="Beige"| [[Electrolyte  disturbance]], [[ethanol]], [[hemochromatosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Atrial myxoma]], [[Bronchogenic carcinoma]], [[Cardiac tumors]], [[Lung cancer]], [[Pheochromocytoma]], [[Porfimer sodium]]
|bgcolor="Beige"| [[Atrial myxoma]], [[bronchogenic  carcinoma]], [[cardiac tumors]], [[lung cancer]], [[pheochromocytoma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
| '''Overdose/Toxicity'''
|bgcolor="Beige"| [[Alcohol]], [[Alcohol withdrawal]], Breath spray which contains alcohol, <ref name="pmid2914028">{{cite journal| author=Ridker PM, Gibson CM, Lopez R| title=Atrial fibrillation induced by breath spray. | journal=N Engl J Med | year= 1989 | volume= 320 | issue= 2 | pages= 124 | pmid=2914028 | doi= | pmc= | url= }} </ref> [[Caffeine]], [[Cocaine]], Tea
|bgcolor="Beige"| [[Alcohol]], [[cocaine]], [[ciclosporin|cyclosporine toxicity]], [[methamphetamines]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 102: Line 122:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| [[Bronchogenic carcinoma]], [[Hypoxia]], [[Lung cancer]], [[Pneumonia]], [[Porfimer sodium]], [[Pulmonary embolism]], [[Pulmonary hypertension]], [[Sarcoidosis]]
|bgcolor="Beige"| [[Bronchogenic carcinoma]], [[chronic obstructive  pulmonary disease]], [[hypoxia]], [[lung cancer]], [[obstructive sleep apnea]], [[pneumonia]], [[pulmonary embolism]], [[pulmonary  hypertension]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Albuminuria]], [[Electrolyte disturbances]], [[Renal insufficiency]]
|bgcolor="Beige"| [[Channelopaties ]], [[chronic kidney  disease]], [[renal insufficiency]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Collagen vascular disease]], [[Interleukin 11]], [[Rheumatic fever]], [[Sarcoidosis]]
|bgcolor="Beige"| [[Collagen vascular disease]], [[rheumatic fever]], [[rheumatic heart  disease]], [[sarcoidosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| [[Myocardial contusion]]
|bgcolor="Beige"| No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Channelopaties]] particularly abnormalities in the sodium channels, [[Hypoxia]], [[Interleukin 11]]
|bgcolor="Beige"| [[Breath spray]], [[caffeine]], [[dehydration]], [[ethanol]], [[fatigue]], [[hypothermia]], [[psychological stress]], [[surgery]]
|-
|-
|}
|}


===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
 
{{columns-list|
*[[Acute myocardial infarction]]
*[[Alcohol]]
*[[Alcohol]]
*[[Alcoholic cardiomyopathy]]
*[[Alcohol withdrawal]]
*[[Alcohol withdrawal]]
*[[Amphetamine]]
*[[atrial infarction|Atrial ischemia]]  
*[[atrial infarction|Atrial ischemia]]  
*[[Atrial myxoma]]
*[[Atrial myxoma]]
*[[Atrial septal defect]]
*[[Atrial septal defect]]<ref name="Tikoff-1968">{{Cite journal  | last1 = Tikoff | first1 = G. | last2 = Schmidt | first2 = AM. | last3 = Hecht | first3 = HH. | title = Atrial fibrillation in atrial septal defect. | journal = Arch Intern Med | volume = 121 | issue = 5 | pages = 402-5 | month = May | year = 1968 | doi =  | PMID = 5645716 }}</ref>
*[[Breath spray]]<ref name="pmid2914028">{{cite journal| author=Ridker PM, Gibson CM, Lopez R| title=Atrial fibrillation induced by breath spray. | journal=N Engl J Med | year= 1989 | volume= 320 | issue= 2 | pages= 124 | pmid=2914028 | doi= | pmc= | url= }} </ref>
*[[Bronchogenic carcinoma]]
*[[Bronchogenic carcinoma]]
*[[Caffeine]]
*[[Caffeine]]
*[[Cardiac surgery]]
*[[Cardiac tumors]]
*[[Cardiac tumors]]
*[[Cardiomyopathy]]
*[[Cardiomyopathy]]
*[[Caspofungin acetate]]
*[[Channelopaties]]  
*[[Channelopaties]]  
*[[Chronic kidney disease]]
*[[Chronic kidney disease]]
*[[Chronic obstructive pulmonary disease]]
*[[Chronic obstructive pulmonary disease]]<ref name="Buch-2003">{{Cite journal  | last1 = Buch | first1 = P. | last2 = Friberg | first2 = J. | last3 = Scharling | first3 = H. | last4 = Lange | first4 = P. | last5 = Prescott | first5 = E. | title = Reduced lung function and risk of atrial fibrillation in the Copenhagen City Heart Study. | journal = Eur Respir J | volume = 21 | issue = 6 | pages = 1012-6 | month = Jun | year = 2003 | doi =  | PMID = 12797497 }}</ref>
*[[Cocaine]]
*[[Cocaine]]
*[[Collagen vascular disease]]
*[[Collagen vascular disease]]
*[[Conduction disorders]]
*[[Congenital heart disease]]
*[[Congenital heart disease]]
*[[Congestive heart failure]]
*[[Congestive heart failure]]
Line 153: Line 178:
*[[Coronary artery bypass graft surgery]]
*[[Coronary artery bypass graft surgery]]
*[[Coronary artery disease]]
*[[Coronary artery disease]]
*[[Cyclophosphamide]]
*[[ciclosporin|Cyclosporine toxicity]]
*[[Dehydration]]
*[[Dehydration]]
*[[Diabetes]]
*[[Diabetes]]<ref name="Benjamin-1994">{{Cite journal  | last1 = Benjamin | first1 = EJ. | last2 = Levy | first2 = D. | last3 = Vaziri | first3 = SM. | last4 = D'Agostino | first4 = RB. | last5 = Belanger | first5 = AJ. | last6 = Wolf | first6 = PA. | title = Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. | journal = JAMA | volume = 271 | issue = 11 | pages = 840-4 | month = Mar | year = 1994 | doi =  | PMID = 8114238 }}</ref>
*[[Dilated cardiomyopathy]]
*[[Dilated cardiomyopathy]]
*[[Electrolyte disturbance]]
*[[Electrolyte disturbance]]
*[[Eisenmenger syndrome]]
*[[Endocarditis]]
*[[Endocarditis]]
*[[Endomyocardial fibrosis]]
*[[Ethanol]]
*[[Etravirine]]
*[[Familial atrial fibrillation ]]
*[[Familial atrial fibrillation ]]
*[[Fatigue]]
*[[Fatigue]]
*[[Heart failure]]
*[[Febuxostat]]
*[[Felbamate]]
*[[Granisetron]]
*[[Graves disease]]
*[[Guanidine]]
*[[Hemochromatosis]]
*[[Hemochromatosis]]
*[[Hypertensive heart disease]]<ref name="Krahn-1995">{{Cite journal  | last1 = Krahn | first1 = AD. | last2 = Manfreda | first2 = J. | last3 = Tate | first3 = RB. | last4 = Mathewson | first4 = FA. | last5 = Cuddy | first5 = TE. | title = The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. | journal = Am J Med | volume = 98 | issue = 5 | pages = 476-84 | month = May | year = 1995 | doi = 10.1016/S0002-9343(99)80348-9 | PMID = 7733127 }}</ref><ref name="Kannel-1982">{{Cite journal  | last1 = Kannel | first1 = WB. | last2 = Abbott | first2 = RD. | last3 = Savage | first3 = DD. | last4 = McNamara | first4 = PM. | title = Epidemiologic features of chronic atrial fibrillation: the Framingham study. | journal = N Engl J Med | volume = 306 | issue = 17 | pages = 1018-22 | month = Apr | year = 1982 | doi = 10.1056/NEJM198204293061703 | PMID = 7062992 }}</ref>
*[[Hyperthyroidism]]
*[[Hyperthyroidism]]
*[[Hypertrophic cardiomyopathy]]
*[[Hypertrophic cardiomyopathy]]<ref name="Robinson-1990">{{Cite journal  | last1 = Robinson | first1 = K. | last2 = Frenneaux | first2 = MP. | last3 = Stockins | first3 = B. | last4 = Karatasakis | first4 = G. | last5 = Poloniecki | first5 = JD. | last6 = McKenna | first6 = WJ. | title = Atrial fibrillation in hypertrophic cardiomyopathy: a longitudinal study. | journal = J Am Coll Cardiol | volume = 15 | issue = 6 | pages = 1279-85 | month = May | year = 1990 | doi =  | PMID = 2329232 }}</ref><ref name="Cecchi-1995">{{Cite journal  | last1 = Cecchi | first1 = F. | last2 = Olivotto | first2 = I. | last3 = Montereggi | first3 = A. | last4 = Santoro | first4 = G. | last5 = Dolara | first5 = A. | last6 = Maron | first6 = BJ. | title = Hypertrophic cardiomyopathy in Tuscany: clinical course and outcome in an unselected regional population. | journal = J Am Coll Cardiol | volume = 26 | issue = 6 | pages = 1529-36 | month = Nov | year = 1995 | doi = 10.1016/0735-1097(95)00353-3 | PMID = 7594081 }}</ref>
*[[Hypothermia]]
*[[Hypothermia]]
*[[Hypothyroidism]]
*[[Hypothyroidism]]
*[[Hypoxia]]
*[[Hypoxia]]
*[[Idiopathic pericarditis]]
*[[Ibrutinib]]
*[[Idarubicin hydrochloride]]
*[[Interleukin 2]]
*[[Ioxilan]]
*[[Ischemic heart disease]]
*[[Lacosamide]]
*[[Left ventricular hypertrophy]]
*[[Left ventricular hypertrophy]]
*[[Lung cancer]]
*[[Lung cancer]]
*[[Lutembacher syndrome]]
*[[Lutembacher syndrome]]
*[[Metabolic syndrome]]
*[[McLeod syndrome]]
*[[Methamphetamines]]
*[[Methamphetamines]]
*[[Mitral regurgitation]]
*[[Metipranolol]]
*[[Mitral regurgitation]]<ref name="Grigioni-2002">{{Cite journal  | last1 = Grigioni | first1 = F. | last2 = Avierinos | first2 = JF. | last3 = Ling | first3 = LH. | last4 = Scott | first4 = CG. | last5 = Bailey | first5 = KR. | last6 = Tajik | first6 = AJ. | last7 = Frye | first7 = RL. | last8 = Enriquez-Sarano | first8 = M. | title = Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome. | journal = J Am Coll Cardiol | volume = 40 | issue = 1 | pages = 84-92 | month = Jul | year = 2002 | doi =  | PMID = 12103260 }}</ref>
*[[Mitral stenosis]]
*[[Mitral stenosis]]
*[[Myocardial infarction]]
*[[Myocardial infarction]]<ref name="Zimetbaum-2000">{{Cite journal  | last1 = Zimetbaum | first1 = PJ. | last2 = Josephson | first2 = ME. | last3 = McDonald | first3 = MJ. | last4 = McClennen | first4 = S. | last5 = Korley | first5 = V. | last6 = Ho | first6 = KK. | last7 = Papageorgiou | first7 = P. | last8 = Cohen | first8 = DJ. | title = Incidence and predictors of myocardial infarction among patients with atrial fibrillation. | journal = J Am Coll Cardiol | volume = 36 | issue = 4 | pages = 1223-
7 | month = Oct | year = 2000 | doi =  | PMID = 11028474 }}</ref>
*[[Myocarditis]]
*[[Myocarditis]]
*[[Niacin]]
*[[Obstructive sleep apnea]]
*[[Obstructive sleep apnea]]
*[[Oprelvekin]]
*[[atrioventricular block|Partial atrioventricular block]]
*[[Pergolide]]
*[[Pericarditis]]  
*[[Pericarditis]]  
*[[Peripartum cardiomyopathy]]
*[[Peripartum cardiomyopathy]]<ref name="WALSH-1965">{{Cite journal  | last1 = WALSH | first1 = JJ. | last2 = BURCH | first2 = GE. | last3 = BLACK | first3 = WC. | last4 = FERRANS | first4 = VJ. | last5 = HIBBS | first5 = RG. | title = IDIOPATHIC MYOCARDIOPATHY OF THE PUERPERIUM (POSTPARTAL HEART DISEASE). | journal = Circulation | volume = 32 | issue =  | pages = 19-31 | month = Jul | year = 1965 | doi =  | PMID = 14314486 }}</ref>
*[[Pheochromocytoma]]
*[[Pheochromocytoma]]
*[[Pneumonia]]
*[[Pneumonia]]
*[[Porfimer sodium]]
*[[Porfimer sodium]]
*[[Pramipexole]]
*[[Psychological stress]]
*[[Psychological stress]]
*[[Pulmonary embolism]]
*[[Pulmonary embolism]]<ref name="Goldhaber-1999">{{Cite journal  | last1 = Goldhaber | first1 = SZ. | last2 = Visani | first2 = L. | last3 = De Rosa | first3 = M. | title = Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER) | journal = Lancet | volume = 353 | issue = 9162 | pages = 1386-9 | month = Apr | year = 1999 | doi =  | PMID = 10227218 }}</ref>
*[[Pulmonary hypertension]]
*[[Pulmonary hypertension]]
*[[Renal insufficiency]]
*[[Renal insufficiency]]
*[[Rheumatic heart disease]]
*[[Rheumatic fever]]
*[[Rheumatic heart disease]]<ref name="Grigioni-2002">{{Cite journal  | last1 = Grigioni | first1 = F. | last2 = Avierinos | first2 = JF. | last3 = Ling | first3 = LH. | last4 = Scott | first4 = CG. | last5 = Bailey | first5 = KR. | last6 = Tajik | first6 = AJ. | last7 = Frye | first7 = RL. | last8 = Enriquez-Sarano | first8 = M. | title = Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome. | journal = J Am Coll Cardiol | volume = 40 | issue = 1 | pages = 84-92 | month = Jul | year = 2002 | doi =  | PMID = 12103260 }}</ref>
*[[Ropinirole]]
*[[Sarcoidosis]]
*[[Sarcoidosis]]
*[[Short QT syndrome]]
*[[Sick sinus syndrome]]
*[[Sinoatrial block]]
*[[Stroke]]
*[[Stroke]]
*[[Subarachnoid hemorrhage]]
*[[Subarachnoid hemorrhage]]
*[[Surgery]]
*[[Surgery]]
*[[Systemic hypertension]]
*[[Tricuspid regurgitation]]
*[[Tricuspid regurgitation]]
*[[Tricuspid stenosis]]
*[[Tricuspid stenosis]]
Line 198: Line 252:
*[[Valvular heart disease]]
*[[Valvular heart disease]]
*[[Viral infections]]
*[[Viral infections]]
 
*[[Wolff-Parkinson-White syndrome]]
===Lone Atrial Fibrillation===
}}
In about 10% of patients no underlying cause is identified.  This condition is called lone atrial fibrillation.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


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Latest revision as of 20:13, 29 August 2021
Resident
Survival
Guide


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

Atrial fibrillation causes 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 Atrial fibrillation causes

CDC on Atrial fibrillation causes

Atrial fibrillation causes in the news

Blogs on Atrial fibrillation causes

Directions to Hospitals Treating Atrial fibrillation causes

Risk calculators and risk factors for Atrial fibrillation causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2] Ogheneochuko Ajari, MB.BS, MS [3]

Overview

The most common cause of atrial fibrillation is atrial dilation associated with hypertension. Atrial fibrillation can be caused by several organic cardiac diseases, but it has also been reported to have a familial etiology in some patients. Approximately 1/3 of patients have familial atrial fibrillation which is due to an underlying genetic disorder. In developed countries, hypertensive heart disease and coronary heart disease are the two most common causes of atrial fibrillation. However, rheumatic heart disease is associated with a higher incidence of atrial fibrillation in developing countries. Life threatening conditions such as acute coronary syndromes, electrolyte imbalance, dehydration, hypoxia, pulmonary embolism, myocarditis and pericarditis should be identified and promptly treated. Other general causes such as the advancing age of the population, the hemodynamic stress of heart failure and valvular heart disease, myocardial ischemia, a variety of inflammatory disorders, pulmonary diseases, alcohol, drug abuse, and endocrine disorders.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. The following are some of the well known life threatening causes of atrial fibrillation:[1][2][3]

Common Causes

The following are the common causes of atrial fibrillation:[4][5][6]

Causes by Organ System

Cardiovascular Alcoholic cardiomyopathy, Atrial ischemia, atrial myxoma, atrial septal defect, cardiac surgery, cardiac tumors, cardiomyopathy, conduction disorders, congenital heart disease, congestive heart failure, constrictive pericarditis, coronary artery bypass graft surgery, coronary artery disease, dilated cardiomyopathy, endocarditis, Eisenmenger syndrome, endomyocardial fibrosis, familial atrial fibrillation, hypertensive heart disease, hypertrophic cardiomyopathy, ischemic heart disease, Lutembacher syndrome, mitral regurgitation, mitral stenosis, myocardial infarction, myocarditis, partial atrioventricular block, pericarditis, peripartum cardiomyopathy, pulmonary embolism, pulmonary hypertension, short QT syndrome, sick sinus syndrome, sinoatrial block, systemic hypertension, tricuspid regurgitation, tricuspid stenosis, unstable angina, uremic pericarditis, valvular heart disease, Wolff-Parkinson-White syndrome
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Amphetamine, caspofungin acetate, conivaptan, cyclophosphamide, cyclosporine toxicity, etravirine, febuxostat, felbamate, granisetron, guanidine, ibrutinib, idarubicin hydrochloride, ioxilan, interleukin 2, lacosamide, metipranolol, niacin, oprelvekin, pergolide, porfimer sodium, pramipexole, ropinirole
Ear Nose Throat No underlying causes
Endocrine Diabetes, Graves disease, hyperthyroidism, hypothyroidism
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic Familial atrial fibrillation, hemochromatosis, McLeod syndrome
Hematologic Hemochromatosis, McLeod syndrome
Iatrogenic No underlying causes
Infectious Disease Viral infections
Musculoskeletal/Orthopedic No underlying causes
Neurologic Stroke, subarachnoid hemorrhage
Nutritional/Metabolic Electrolyte disturbance, ethanol, hemochromatosis
Obstetric/Gynecologic No underlying causes
Oncologic Atrial myxoma, bronchogenic carcinoma, cardiac tumors, lung cancer, pheochromocytoma
Ophthalmologic No underlying causes
Overdose/Toxicity Alcohol, cocaine, cyclosporine toxicity, methamphetamines
Psychiatric No underlying causes
Pulmonary Bronchogenic carcinoma, chronic obstructive pulmonary disease, hypoxia, lung cancer, obstructive sleep apnea, pneumonia, pulmonary embolism, pulmonary hypertension
Renal/Electrolyte Channelopaties , chronic kidney disease, renal insufficiency
Rheumatology/Immunology/Allergy Collagen vascular disease, rheumatic fever, rheumatic heart disease, sarcoidosis
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Breath spray, caffeine, dehydration, ethanol, fatigue, hypothermia, psychological stress, surgery

Causes in Alphabetical Order

References

  1. ↑ Fox, CS.; Parise, H.; D'Agostino, RB.; Lloyd-Jones, DM.; Vasan, RS.; Wang, TJ.; Levy, D.; Wolf, PA.; Benjamin, EJ. (2004). "Parental atrial fibrillation as a risk factor for atrial fibrillation in offspring". JAMA. 291 (23): 2851–5. doi:10.1001/jama.291.23.2851. PMID 15199036. Unknown parameter |month= ignored (help)
  2. ↑ 2.0 2.1 Zimetbaum, PJ.; Josephson, ME.; McDonald, MJ.; McClennen, S.; Korley, V.; Ho, KK.; Papageorgiou, P.; Cohen, DJ. (2000). "Incidence and predictors of myocardial infarction among patients with atrial fibrillation". J Am Coll Cardiol. 36 (4): 1223–7. PMID 11028474. Unknown parameter |month= ignored (help)
  3. ↑ 3.0 3.1 Goldhaber, SZ.; Visani, L.; De Rosa, M. (1999). "Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER)". Lancet. 353 (9162): 1386–9. PMID 10227218. Unknown parameter |month= ignored (help)
  4. ↑ 4.0 4.1 Krahn, AD.; Manfreda, J.; Tate, RB.; Mathewson, FA.; Cuddy, TE. (1995). "The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study". Am J Med. 98 (5): 476–84. doi:10.1016/S0002-9343(99)80348-9. PMID 7733127. Unknown parameter |month= ignored (help)
  5. ↑ 5.0 5.1 Kannel, WB.; Abbott, RD.; Savage, DD.; McNamara, PM. (1982). "Epidemiologic features of chronic atrial fibrillation: the Framingham study". N Engl J Med. 306 (17): 1018–22. doi:10.1056/NEJM198204293061703. PMID 7062992. Unknown parameter |month= ignored (help)
  6. ↑ 6.0 6.1 6.2 Grigioni, F.; Avierinos, JF.; Ling, LH.; Scott, CG.; Bailey, KR.; Tajik, AJ.; Frye, RL.; Enriquez-Sarano, M. (2002). "Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome". J Am Coll Cardiol. 40 (1): 84–92. PMID 12103260. Unknown parameter |month= ignored (help)
  7. ↑ Tikoff, G.; Schmidt, AM.; Hecht, HH. (1968). "Atrial fibrillation in atrial septal defect". Arch Intern Med. 121 (5): 402–5. PMID 5645716. Unknown parameter |month= ignored (help)
  8. ↑ Ridker PM, Gibson CM, Lopez R (1989). "Atrial fibrillation induced by breath spray". N Engl J Med. 320 (2): 124. PMID 2914028.
  9. ↑ Buch, P.; Friberg, J.; Scharling, H.; Lange, P.; Prescott, E. (2003). "Reduced lung function and risk of atrial fibrillation in the Copenhagen City Heart Study". Eur Respir J. 21 (6): 1012–6. PMID 12797497. Unknown parameter |month= ignored (help)
  10. ↑ Benjamin, EJ.; Levy, D.; Vaziri, SM.; D'Agostino, RB.; Belanger, AJ.; Wolf, PA. (1994). "Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study". JAMA. 271 (11): 840–4. PMID 8114238. Unknown parameter |month= ignored (help)
  11. ↑ Robinson, K.; Frenneaux, MP.; Stockins, B.; Karatasakis, G.; Poloniecki, JD.; McKenna, WJ. (1990). "Atrial fibrillation in hypertrophic cardiomyopathy: a longitudinal study". J Am Coll Cardiol. 15 (6): 1279–85. PMID 2329232. Unknown parameter |month= ignored (help)
  12. ↑ Cecchi, F.; Olivotto, I.; Montereggi, A.; Santoro, G.; Dolara, A.; Maron, BJ. (1995). "Hypertrophic cardiomyopathy in Tuscany: clinical course and outcome in an unselected regional population". J Am Coll Cardiol. 26 (6): 1529–36. doi:10.1016/0735-1097(95)00353-3. PMID 7594081. Unknown parameter |month= ignored (help)
  13. ↑ WALSH, JJ.; BURCH, GE.; BLACK, WC.; FERRANS, VJ.; HIBBS, RG. (1965). "IDIOPATHIC MYOCARDIOPATHY OF THE PUERPERIUM (POSTPARTAL HEART DISEASE)". Circulation. 32: 19–31. PMID 14314486. Unknown parameter |month= ignored (help)


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