Atrial fibrillation
Conduction | ||
Sinus rhythm | Atrial fibrillation |
Atrial fibrillation | |
The P waves, which represent depolarization of the atria, are irregular or absent during atrial fibrillation. | |
ICD-10 | I48 |
ICD-9 | 427.31 |
DiseasesDB | 1065 |
MedlinePlus | 000184 |
eMedicine | med/184 emerg/46 |
Cardiology Network |
Discuss Atrial fibrillation further in the WikiDoc Cardiology Network |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Synonyms and related keywords: AF, Afib, fib
Overview
Overview
Epidemiology
Diagnosis
Overview
Classification
Etiology and Differential Diagnosis
Treatment
Pharmacological Treatment
Invasive Treatment
Surgical Treatment
Follow up & Secondary prevention
Risk factors for ischemic stroke or systemic embolization in patient with non valvular atrial fibrillation
Numbers represents relative risks[1]
- Advanced age (continuous, per decade) 1.4
- History of hypertension 1.6
- Heart failure or impaired left ventricular systolic function 1.4
- Coronary artery disease (CAD) 1.5
- Diabetes mellitus (DM) 1.7
- Previous stroke or Transient Ischemic Attack (TIA) 2.5
Clinical Trial Data
Results from the Pulmonary Vein Antrum Isolation versus AV Node Ablation with Bi-Ventricular Pacing for Treatment of Atrial Fibrillation in Patients with Congestive Heart Failure (PABA-CHF) study suggest that pulmonary-vein (PV) isolation leads to better morphologic and functional results than atrioventricular (AV) node ablation with biventricular pacing for congestive heart failure (CHF) in patients with atrial fibrillation.
In this prospective, multicenter study, 41 patients were randomized to PV isolation and 40 to AV node ablation with biventricular pacing. At 6 months, patients in the PV isolation group had higher mean ejection fractions (35% vs 29%, p<0.001), greater 6 minute distances walked (340 vs 297 meters, p <0.001), and better quality of life scores as determined by the Minnesota Living with Heart Failure questionnaire (60 vs 82, p<0.001, where lower scores indicate better quality of life) than those in the AV node ablation arm.
These PABA-CHF study findings thus suggest the potential advantages of performing PV isolation over AV node ablation with biventricular pacing for this patient population.
Noted limitations of the study include using sites with extensive experience in performing ablations, an unblinded study design, and a relatively short follow-up time. (NEJM by Mohammed N. Khan, et al.)
Guidelines: Diagnosis and Management of Atrial Fibrillation
External links
- American Heart Association's page on atrial fibrillation
- Atrial fibrillation
- Bandolier: Evidence-based medicine resource on atrial fibrillation
- Cleveland Clinic Webchat - Atrial Fibrillation Webchat with Dr. Jennifer Cummings
See also
References
- ↑ Estes NAM 3rd, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS, McNamara RL, Messer JV, Ritchie JL, Romeo SJW, Waldo AL, Wyse DG. ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with non valvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Performance Measures for Atrial Fibrillation). Circulation 2008; 117:1101–1120
Further Readings
- Fuster V, Rydén LE, Cannom DS, et al (2006). "ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: 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 (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". Circulation 114 (7): e257-354. doi:10.1161/CIRCULATIONAHA.106.177292. PMID 16908781.
- Estes NAM 3rd, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS, McNamara RL, Messer JV, Ritchie JL, Romeo SJW, Waldo AL, Wyse DG. ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with non valvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Performance Measures for Atrial Fibrillation). Circulation 2008; 117:1101–1120
- Braunwald's Heart Disease, Libby P, 8th ed., 2007, ISBN 978-1-41-604105-4
- Hurst's the Heart, Fuster V, 12th ed. 2008, ISBN 978-0-07-149928-6
- Willerson JT, Cardiovascular Medicine, 3rd ed., 2007, ISBN 978-1-84628-188-4
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