From the Guidelines
Atrial fibrillation (AFib) is a common heart condition characterized by an irregular and often rapid heartbeat, which can lead to symptoms such as palpitations, shortness of breath, and fatigue, and increases the risk of stroke, heart failure, and other thromboembolic outcomes 1.
Key Characteristics of AFib
- The prevalence of AFib is expected to double in the next few decades due to the ageing population and increasing burden of comorbidities 1.
- AFib can be classified into different types, including paroxysmal, persistent, and permanent, and its effects on individual patients can vary widely 1.
- The condition is often associated with comorbidities such as hypertension, coronary artery disease, and congestive heart failure, as well as non-cardiac causes like hyperthyroidism and hypoxic pulmonary conditions 1.
Management of AFib
- The management of AFib typically involves a combination of rate control, rhythm control, and anticoagulation therapies, with the goal of preventing stroke and improving symptoms 1.
- Rate control can be achieved with medications such as beta blockers or calcium channel blockers, while rhythm control may involve anti-arrhythmic medications like amiodarone or flecainide 1.
- Anticoagulation with medications like apixaban or rivaroxaban is crucial to prevent stroke, particularly in patients with high-risk factors 1.
Patient-Centered Approach
- A patient-centered approach to managing AFib is essential, taking into account individual patient characteristics, symptoms, and preferences 1.
- Patient empowerment and education are critical in achieving better outcomes and encouraging adherence to treatment plans 1.
- Healthcare professionals should work with patients to develop personalized management plans, incorporating the latest evidence-based guidelines and recommendations 1.
From the Research
Definition and Characteristics of Atrial Fibrillation
- Atrial fibrillation (AFib) is the most common sustained cardiac rhythm disorder, characterized by a rapid and irregular heartbeat 2, 3, 4, 5, 6.
- It can be asymptomatic or lead to symptoms such as palpitations, dyspnea, dizziness, exertional dyspnea, fatigue, and chest pain 2, 3, 4.
- The condition is associated with serious complications, including an increased risk of stroke, heart failure, and other thromboembolic events 2, 3, 4, 5, 6.
Diagnosis and Assessment
- Diagnosis is based on history and physical examination findings and should be confirmed with 12-lead electrocardiography or other recording device 3.
- The initial evaluation should include transthoracic echocardiography, serum electrolyte levels, complete blood count, and thyroid, kidney, and liver function tests 3.
- Stroke risk should be assessed in patients with atrial fibrillation using the CHA2DS2-VASc score 3.
Management and Treatment
- Management strategies include stroke prevention, rate control, and rhythm control 2, 3, 4.
- Warfarin and direct oral anticoagulants can reduce the risk of stroke by preventing atrial thrombus formation and subsequent cerebral or systemic emboli 3.
- Hemodynamically unstable patients should be evaluated and treated emergently, while most hemodynamically stable patients should be treated initially with rate control and anticoagulation 3.
- Rhythm control, using medications or procedures, should be considered in patients with hemodynamic instability or in some patients based on risk factors and shared decision-making 3.