Atrial Fibrillation is an important part of ACLS program.

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).