Atrial fibrillation laboratory findings: Difference between revisions
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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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| [[File:Critical_Pathways.gif|88px|link=Atrial fibrillation critical pathways]]|| <br> || <br> | |||
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| <small>Sinus rhythm</small> [[Image:Heart conduct sinus.gif|none|75px]] | |||
| <small>Atrial fibrillation</small> [[Image:Heart conduct atrialfib.gif|none|100px]] | |||
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{{Template:Atrial fibrillation}} | {{Template:Atrial fibrillation}} | ||
{{CMG}} | {{CMG}} {{AE}} {{Anahita}} | ||
== | ==Overview== | ||
Many cases of [[atrial fibrillation]] ([[AF]]) have no definite cause, it may be the result of various other problems. Nevertheless, [[thyroid function tests|thyroid function]] tests are required, especially for a first episode of [[atrial fibrillation]] ([[AF]]), when the [[ventricle|ventricular]] rate is difficult to control, or when [[atrial fibrillation]] ([[AF]]) recurs unexpectedly after [[cardioversion]]. [[Renal function]] and [[electrolyte]]s are routinely performed in [[patients]] suffering from [[atrial fibrillation]]. In addition, in acute-onset [[atrial fibrillation]] associated with [[chest pain]], [[troponin|cardiac troponins]] or other markers of damage to the [[myocardium|heart muscle]] may be ordered. | |||
==Laboratory Findings== | |||
*[[Thyroid]] function tests : [[Thyroid-stimulating hormone]] ([[TSH]]) is commonly suppressed in [[hyperthyroidism]] and of relevance if [[amiodarone]] is administered for [[treatment]].<ref name="pmid8885821">{{cite journal| author=Krahn AD, Klein GJ, Kerr CR, Boone J, Sheldon R, Green M | display-authors=etal| title=How useful is thyroid function testing in patients with recent-onset atrial fibrillation? The Canadian Registry of Atrial Fibrillation Investigators. | journal=Arch Intern Med | year= 1996 | volume= 156 | issue= 19 | pages= 2221-4 | pmid=8885821 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8885821 }} </ref> | |||
In acute-onset [[AF]] associated with [[chest pain]], [[troponin|cardiac troponins]] or other markers of damage to the heart muscle may be ordered. [[Coagulation]] studies ([[International normalized ratio|INR]]/aPTT) are usually performed, as [[anticoagulant]] medication may be commenced.<ref name=" | *[[Renal function]] and [[electrolyte]]s are routinely performed in [[patients]] suffering from [[atrial fibrillation]]. | ||
*[[Complete blood count]] | |||
*[[Cardiac markers]] : In acute-onset [[atrial fibrillation]] ([[AF]]) associated with [[chest pain]], [[troponin|cardiac troponins]] or other markers of damage to the [[myocardium|heart muscle]] may be ordered. | |||
*[[Coagulation]] studies ([[International normalized ratio|INR]]/[[aPTT]]) are usually performed, as [[anticoagulant]] [[medication]] may be commenced. | |||
*High [[Sensitivity (tests)|sensitivity]] [[C-reactive protein]] ([[C-reactive protein|hs-CRP]]) could act as a predictive marker for [[cardiology|cardiac related]] complications and death.<ref name="pmid21962993">{{cite journal| author=Hermida J, Lopez FL, Montes R, Matsushita K, Astor BC, Alonso A| title=Usefulness of high-sensitivity C-reactive protein to predict mortality in patients with atrial fibrillation (from the Atherosclerosis Risk In Communities [ARIC] Study). | journal=Am J Cardiol | year= 2012 | volume= 109 | issue= 1 | pages= 95-9 | pmid=21962993 | doi=10.1016/j.amjcard.2011.08.010 | pmc=4062871 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21962993 }} </ref><ref name="pmid11282915">{{cite journal| author=Ridker PM| title=High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease. | journal=Circulation | year= 2001 | volume= 103 | issue= 13 | pages= 1813-8 | pmid=11282915 | doi=10.1161/01.cir.103.13.1813 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11282915 }} </ref> | |||
*It is recommended to calculate [[time in therapeutic range]] ([[time in therapeutic range|TTR]]) for [[patients]] who are under [[treatment]] for [[atrial fibrillation]].<ref name="pmid34020968">{{cite journal| author=Perry M, Kemmis Betty S, Downes N, Andrews N, Mackenzie S, Guideline Committee| title=Atrial fibrillation: diagnosis and management-summary of NICE guidance. | journal=BMJ | year= 2021 | volume= 373 | issue= | pages= n1150 | pmid=34020968 | doi=10.1136/bmj.n1150 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34020968 }} </ref> | |||
**Based on NICE guideline usage of a sound method such as the Rosendaal method is recommended. | |||
**It is recommended to exclude measures of the first 6 weeks of [[treatment]]. | |||
**[[Time in therapeutic range]] ([[time in therapeutic range|TTR]]) is more trusted if it is calculated over at least 6 months of a period. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{ | {{WH}} | ||
{{ | {{WS}} | ||
[[CME Category::Cardiology]] | |||
[[Category:Cardiology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Up-To-Date cardiology]] | |||
[[Category:Arrhythmia]] | |||
[[Category:Electrophysiology]] | [[Category:Electrophysiology]] | ||
[[Category: | [[Category:Disease]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
Latest revision as of 06:04, 13 October 2021
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Resident Survival Guide |
| File:Critical Pathways.gif |
Sinus rhythm  |
Atrial fibrillation  |
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Atrial Fibrillation Microchapters | |
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Special Groups | |
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Diagnosis | |
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Treatment | |
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Cardioversion | |
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Anticoagulation | |
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Surgery | |
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Case Studies | |
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Atrial fibrillation laboratory findings On the Web | |
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Directions to Hospitals Treating Atrial fibrillation laboratory findings | |
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Risk calculators and risk factors for Atrial fibrillation laboratory findings | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]
Overview
Many cases of atrial fibrillation (AF) have no definite cause, it may be the result of various other problems. Nevertheless, thyroid function tests are required, especially for a first episode of atrial fibrillation (AF), when the ventricular rate is difficult to control, or when atrial fibrillation (AF) recurs unexpectedly after cardioversion. Renal function and electrolytes are routinely performed in patients suffering from atrial fibrillation. In addition, in acute-onset atrial fibrillation associated with chest pain, cardiac troponins or other markers of damage to the heart muscle may be ordered.
Laboratory Findings
- Thyroid function tests : Thyroid-stimulating hormone (TSH) is commonly suppressed in hyperthyroidism and of relevance if amiodarone is administered for treatment.[1]
- Renal function and electrolytes are routinely performed in patients suffering from atrial fibrillation.
- Complete blood count
- Cardiac markers : In acute-onset atrial fibrillation (AF) associated with chest pain, cardiac troponins or other markers of damage to the heart muscle may be ordered.
- Coagulation studies (INR/aPTT) are usually performed, as anticoagulant medication may be commenced.
- High sensitivity C-reactive protein (hs-CRP) could act as a predictive marker for cardiac related complications and death.[2][3]
- It is recommended to calculate time in therapeutic range (TTR) for patients who are under treatment for atrial fibrillation.[4]
- Based on NICE guideline usage of a sound method such as the Rosendaal method is recommended.
- It is recommended to exclude measures of the first 6 weeks of treatment.
- Time in therapeutic range (TTR) is more trusted if it is calculated over at least 6 months of a period.
References
- ↑ Krahn AD, Klein GJ, Kerr CR, Boone J, Sheldon R, Green M; et al. (1996). "How useful is thyroid function testing in patients with recent-onset atrial fibrillation? The Canadian Registry of Atrial Fibrillation Investigators". Arch Intern Med. 156 (19): 2221–4. PMID 8885821.
- ↑ Hermida J, Lopez FL, Montes R, Matsushita K, Astor BC, Alonso A (2012). "Usefulness of high-sensitivity C-reactive protein to predict mortality in patients with atrial fibrillation (from the Atherosclerosis Risk In Communities [ARIC] Study)". Am J Cardiol. 109 (1): 95–9. doi:10.1016/j.amjcard.2011.08.010. PMC 4062871. PMID 21962993.
- ↑ Ridker PM (2001). "High-sensitivity C-reactive protein: potential adjunct for global risk assessment in the primary prevention of cardiovascular disease". Circulation. 103 (13): 1813–8. doi:10.1161/01.cir.103.13.1813. PMID 11282915.
- ↑ Perry M, Kemmis Betty S, Downes N, Andrews N, Mackenzie S, Guideline Committee (2021). "Atrial fibrillation: diagnosis and management-summary of NICE guidance". BMJ. 373: n1150. doi:10.1136/bmj.n1150. PMID 34020968 Check
|pmid=value (help).