Atrial Fibrillation

ATRIAL FIBRILLATION

A type of arrhythmia where atria are disorganised and multiple atrial foci fire impulses at a rate of 350-600 per minute.

• Atria does not contract but only fibrillates.

• Atrial fibrillation can be paroxysmal or persistent.

Causes:

• Thyrotoxicosis
• Hypertensive Heart Disease
• Rheumatic Valvular Heart Disease
• Ischaemic Heart Disease
• Lower lobe pneumonia, COPD
• Lone Atrial Fibrillations
• Pericardial diseases

Clinical Features:

Symptoms

• Palpitations
• Fatigue
• Syncope
• Angina

Signs

• Irregularly irregular pulse
• Apex-Pulse deficit
• Hypotension
• Absent 'a' waves on JVP
• Varying intensity of first heart sound
• ECG - absent p waves

Complications:

• Syncope
• Thromboembolism
• Angina
• Worsening cardiac failue or pulmonary oedema

Treatment:

• Diltiazem / Verapamil / Propranolol / Digoxin

(To slow ventricular rate)

• Warfarin / Heparin

(Anti-thrombotic therapy)

• Quinidine / Amiodarone / Disopyramide / Propranolol

(For preservation of sinus rhythm)

Can any of you help me out here?

How does MR or MS lead to Atrial Fibrillation. Please give the step by step break down.

THANKS!