Atrial Fibrillation
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.
NOTE: Patients with WPW may present with atrial fibrillation with rapid ventricular response, commonly mistaken for ventricular tachycardia or fibrillation.
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