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Tachycardia: Difference between revisions
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====Clinical diagnosis:==== | ====Clinical diagnosis:==== | ||
Atrial fibrillation is the most common supraventricular arrhythmia in Western society. It is characterized by the absence of clear P-waves on the surface ECG and an irregular ventricular ventricular rate. On physical examination an irregular pulse can be felt, however this is not diagnostic of atrial fibrillation as other causes can cause an irregular pulse (atrial or ventricular extra systoles). The cardiac output is reduced due to lack of atrial kick. Furthermore due to the higher ventricular rate the heart has not enough time to completely fill with blood. Atrial fibrillation is classified according to the clinical presentation of atrial fibrillation:<cite>Camm2010</cite> | Atrial fibrillation is the most common supraventricular arrhythmia in Western society. Patients can experience complaints from palpitations, dyspnuea and dizziness. It is characterized by the absence of clear P-waves on the surface ECG and an irregular ventricular ventricular rate. On physical examination an irregular pulse can be felt, however this is not diagnostic of atrial fibrillation as other causes can cause an irregular pulse (atrial or ventricular extra systoles).The cardiac output is reduced due to lack of atrial kick. Furthermore due to the higher ventricular rate the heart has not enough time to completely fill with blood. The development of AF is associated with different diseases for instance hypertension, mitral valve disease, thyroid disease and diabetes. AF usually starts with short single isolated episodes of AF which are self terminating. Progressivly over time these episodes are of longer duration and occur more frequently. These episodes progress to persistent AF, which last longer than 7 days or can only be terminated by cardioversion. In the end AF is permanent en AF is not possible or duration of sinus rhythm is short. Episodes of AF can be symptomatic, but patients can experience no symptoms during AF. Atrial fibrillation is classified according to the clinical presentation of atrial fibrillation:<cite>Camm2010</cite> | ||
* Paroxysmal atrial fibrillation: Episodes atrial fibrillation lasting shorter than 7 days and terminating spontaneously | * Paroxysmal atrial fibrillation: Episodes atrial fibrillation lasting shorter than 7 days and terminating spontaneously | ||
* Persistent atrial fibrillation: Episodes of atrial fibrillation not terminating spontaneously or lasting longer than 7 days | * Persistent atrial fibrillation: Episodes of atrial fibrillation not terminating spontaneously or lasting longer than 7 days | ||
* Long standing persistent atrial fibrillation: Persistent atrial fibrillation for more than one year. | * Long standing persistent atrial fibrillation: Persistent atrial fibrillation for more than one year. | ||
* Permanent atrial fibrillation: Accepted atrial fibrillation, no strategies of rhythm control are pursued. | * Permanent atrial fibrillation: Accepted atrial fibrillation, no strategies of rhythm control are pursued. | ||
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