Atrial Fibrillation

Created by team@ekgdx.com on Feb. 12, 2023

Let’s talk about atrial fibrillation (AFIB).

AFIB is recognized on an EKG when the rhythm is grossly irregular with absent P waves. Atrial activity is represented by fibrillatory (f) waves. It is the most common arrhythmia encountered in clinical practice.

Criteria

  • Irregularly irregular R-R intervals.
  • Absent P waves . 
  • Presence of fibrillatory (f) waves.

 

Note the irregular R-R intervals with absent P waves. The fibrillatory (f) waves are evident. 

 

Same rhythm strip with graphical explanation. 

 

AFIB with RVR (rapid ventricular response)

 

Possible causes: Valve heart disease, MI, PE, chronic lung disease, heart disease, sick sinus syndrome, thyrotoxicosis, hypoxia, WPW, alcohol (“holiday heart” syndrome), others.

NOTE: If R-R interval is regular and slow, consider third-degree AV block.

NOTE: If QRS is wide (>0.12 sec.) consider pre existing BBB, aberrancy or accessory bypass tract.

NOTEPatients with WPW may present with atrial fibrillation with rapid ventricular response, commonly mistaken for ventricular tachycardia or fibrillation.

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References

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Thanks for joining us. 

Dr. Roig

Atrial Fibrillation