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In the Clinic |

Atrial Fibrillation

Peter Zimetbaum, MD
Ann Intern Med. 2010;153(11):ITC6-1. doi:10.7326/0003-4819-153-11-201012070-01006
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A trial fibrillation (AF) is the most common, clinically significant cardiac arrhythmia. It occurs when a diffuse and chaotic pattern of electrical activity in the atria suppresses or replaces the normal sinus mechanism, leading to deterioration of mechanical function. Atrial fibrillation is a major cause of morbidity, mortality, and health care expenditures; prevalence in the United States is 2.3 million cases and is estimated to increase to 5.6 million by the year 2050 (1). Atrial fibrillation is associated with a 5-fold increased risk for stroke and is estimated to cause 15% of all strokes (2). Independent of coexisting diseases, the presence of AF confers a 2-fold increased risk for all-cause mortality (3).

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Figure 1.

Electrocardiogram showing atrial fibrillation with rapid ventricular rate.

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Grahic Jump Location
Figure 2.

Electrocardiogram showing sinus rhythm with frequent premature atrial contractions.

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Grahic Jump Location
Figure 3.

Atrial flutter. Classic "saw-tooth" flutter waves are seen in all 12 leads, and the ventricular response is mostly regular. (There is a transient change from 2:1 to 4:1 atrioventricular conduction following the 12th QRS complex.)

Grahic Jump Location




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