Atrial Fibrillation

Definition Acute Management Chronic Management Anticoagulation Rhythm / Rate Management

Objectives

1. In a patient who presents with new onset atrial fibrillation, look for an underlying cause (e.g., ischemic heart disease, acute myocardial infarction, congestive heart failure, cardiomyopathy, pulmonary embolus, hyperthyroidism, alcohol, etc.)
2. In a patient presenting with atrial fibrillation,
   • Look for hemodynamic instability,
   • Intervene rapidly and appropriately to stabilize the patient.
3. In an individual presenting with chronic or paroxysmal atrial fibrillation,
   • Explore the need for anticoagulation based on the risk of stroke with the patient,
   • Periodically reassess the need for anticoagulation.
4. In patients with atrial fibrillation, when the decision has been made to use anticoagulation, institute the appropriate therapy and patient education, with a comprehensive follow-up plan.
5. In a stable patient with atrial fibrillation, identify the need for rate control.
6. In a stable patient with atrial fibrillation, arrange for rhythm correction when appropriate.