Atrial Fibrillation

Causes

Ischaemic heart disease (particularly AMI's) Valvular heart disease (particularly Mitral disease) Idiopathic Thyrotoxicosis Hypertension Pulmonary Embolis Pneumonia Alcoholism

Investigations

ECG - confirm AF, previous AMI's CXR - PE, Pneumonia TFT - may cause AF LFT - alcoholic liver disease Echocardiogram - valvular dysfunction

Treatment

Rate Control   Digoxin If ineffective - Verapamil & / or beta-blocker, eg. Atenolol Anticoagulation   Warfarin - INR 2.0 - 3.0 Aspirin may be of some benefit DC Cardioversion   Success depends on the the absence of underlying cardiac problems More likely to be of benefit if performed within 48 hrs of AF