Atrial fibrillation Causes and Treatment Indications of DC Cardioversion

 

Atrial fibrillation TACHYARRHYTHMIASPSVT (Paroxysmal supraventricular Tachycardia) TACHYARRHYTHMIAS SINUS TACHYCARDIA. Read more ... » Indications of DC Cardioversion –

Cardiovasculer examination, RRHYTHMIAS, Sinus TachycardiaSinus Tachycardia and Sinus Bradycardia Definition Causes and Treatment. Read more ... »

 

 

Atrial fibrillation is recognized by :

• ·Absence of P waves
• ·P waves re laced by fibrillatory waves or undulating baseli~at frequency 350-600 perminute
• R waves irregularly irregular and of varying amplitude
• QRS normal.

 

 

CausesSLEEPING SICKNESS OR HUMAN AFRICAN TRY­PANOSOMIASIS (HAT). Read more ... » Of Atrial fibrillation :

• Emotional stress
• AcuteSLEEPING SICKNESS OR HUMAN AFRICAN TRY­PANOSOMIASIS (HAT). Read more ... » alcoholic intoxication
• Hypercapnia
• ChronicChronic Hepatitis Classification viral hepatitis Clinical features and Treatment. Read more ... » lung diseaseSLEEPING SICKNESS OR HUMAN AFRICAN TRY­PANOSOMIASIS (HAT). Read more ... »
• Lone AF
• Exercise
• Hypoxia
• Mitral valve disease
• ASDEisenmenger syndrome (ASD, VSD, PDA With PAH with reversal of shunt - Right-to-Ieft shunt) with Treatment. Read more ... »
• -Hypertensive heartExamination of the Cardiovascular System. Read more ... » disease
• Thyrotoxicosis
• After surgery
• Vasovagal reaction ~RHD

 

TreatmentSLEEPING SICKNESS OR HUMAN AFRICAN TRY­PANOSOMIASIS (HAT). Read more ... »

• Treat the cause, remove the precipitating factor.
• If clinicalSLEEPING SICKNESS OR HUMAN AFRICAN TRY­PANOSOMIASIS (HAT). Read more ... » status is compromised  – electrical cardioversion.

 

DrugSLEEPING SICKNESS OR HUMAN AFRICAN TRY­PANOSOMIASIS (HAT). Read more ... » therapy of atrial fibrillation

• Esmolol, or Esmolol + Digoxin.
• Ibutilide can convert AF to sinus rhythm.
• 1 mg is iven in 10 minutes, and may be repeated in 20 minutes.
• Cannot be given if serum potassium low or QT is prolonged as there is risk of torsade de pointes. QT interval should not be more than 440 msec and serum potassium should beabove 4 meg.
• If AF is for more than 2 days, then cardioversion with Ibutilide attempted only after anticoagulantDeep Vein Thrombosis Embolizations Antiplatelet Anticoagulant Treatment Therapy. Read more ... » therapy has been given for 4 weeks
• Dofetilide is another good drug for cardioversion to sinus rhythm.

 

Contraindications –

• QT interval more than 440 msec
• Thyrotoxicosls
• CHF (congestive heart failureHeart Failure Causes Symptoms NYHA classification with Heart Failure Treatment. Read more ... »)
• Digoxin + Disopyramide for conversion to sinus rhythm.
• If severe LV dysfunction is present then disopyramide is not used.

 

Conditions of DC cardioversion in cases –

• · Failure of drug therapy
• · HypotensionDiabetic Nephropathy and Renal complications of DM (Diabetes Mellitus). Read more ... »
• · Sotalol
• · Anticoagulants to prevent embolization.
• · Rapid ventricular rate
• · Heart failure
• · Amiodarone

 

Indications of DC Cardioversion in AF –

• .Heart rate> 150 per minute causing heart failure, chest painApproach to Chest Pain Differential diagnosis of chest pain. Read more ... », cardiogenic shockShock Presentation Risk Factors Pathogenesis Management Treatment. Read more ... ».
• Patients with HOCM or severe AS – where atrial function is required.
• AF in WPW syndromeMetabolic,Insulin Resistance Syndrome X Causes Symptoms. Read more ... ».

 

For refractory atrial fibrillation

• Ablation therapy.
• Problems like pulmonary vein stenosis, pulmonary hypertensionMetabolic,Insulin Resistance Syndrome X Causes Symptoms. Read more ... » and strokeHyperglycemic Hyperosmolar State (HHS) Acute Complication Of DM. Read more ... » can occur
• Maze procedure.
• Multiple lesions are made in the right and left atria to break electrical conductance and stop propagation of fibrillatory waves.