Atrial fibrillation is an irregular heart rhythm caused by multiple electrical impulses bombarding the atrioventricular node too quickly to process. It is often associated with underlying heart diseases and can cause symptoms like fatigue, dizziness, and an irregular pulse. On ECG, there are no discernible P waves due to the chaotic electrical activity in the atria, and the ventricular rate is usually between 160-180 beats per minute. While often well-tolerated, atrial fibrillation reduces cardiac output and can further compromise the heart if the ventricular rate is not controlled. Treatment depends on stability, with immediate cardioversion for unstable patients and medications or procedures to restore normal rhythm for stable patients.

1. ATRIAL FIBRILLATION
Dr. G.W.M.Zahidul Hasan
SQUARE HOSPITALS LTD
BANGLADESH.
Tachycardia

2. Atrial Fibrillation
Atrial fibrillation is a rhythm resulting from multiple
ectopic foci bombarding ( 400to 700 beats/min) the
AV node, which physiologically cannot handle all of
the impulses.
Causes:
• Underlying heart diseases:
- Valvular heart diseases.
- Hyprttensive heart diseases.
- Coronary heart diseases.
- Cardiac muscle diseases.

3. Sign & Symptom of AF:
• Gradual onset that may related to fever,
dehydration ,pain or blood loss.
• Tachypnea.
• Blood pressure: Variable.
• Heart Rate: Usually < 150 beats/min.
• Peripheral pulse: Normal
• Skin: Pale & cold.
• Fatigue, dizziness.

4. ECG Interpretation:
• Rate: Atrial rate 400-700 per min ( can not be
counted),ventricular rate 160-180 beats /min.
• Rhythm: Irregularly irregular.
• P waves: No P waves present. There are
fibrillatory waves. Resulting chaotic acitivity.
• P-R interval: None.
• QRS complex: Normal.

5. ECG

6. CLINICAL SIGNIFICANCE:
• The atria do not contract. So normal atrial is loss.
• Cardiac output is decrease by 20-25 %.
• If the rate is normal,the rhythm is usually well
tolerated.
• If the rate coupled with loss of the atrial kick,
causes further cardiovascular decompensation.
• Ventricular response less than 60 may
compromise cardiac output, suspect digitalis
toxicity.

7. TREATMENT:
If unstable:
Proceed to immediate sycronized
cardiovarsion.
If stable:
May attempt vagal maneuvers, carotid
massage or medication (Adenosine,
Amiodarone or procainamide).