Atrial Fibrillation with No Structural Heart Disease Should Always Undergo Catheter Ablation

This case study discusses the management of a 68 year old male who presented with chest palpitations secondary to rapid atrial fibrillation. Atrial fibrillation is a common cardiac arrhythmia with serious complications if not treated correctly. This essay will discuss the initial clinical presentation of the patient and examine the management and outcome of the interventions applied. The significance of atrial fibrillation including its pathophysiology and aetiology will also be discussed.

- The goals of treatment include a decrease in ventricular response (to less than 100 beats/minute), prevention of stroke, and conversion to normal sinus rhythm, if possible. To accomplish this, I would expect the health care provider to initially order drugs to control the ventricular rate, such as calcium channel blockers, beta-adrenergic blockers, digoxin, and dronedarone. For some patients, pharmacologic or electrical conversion of the atrial fibrillation to normal sinus rhythm may then also be considered, such as by using amiodarone or electrical cardioversion. If the atrial fibrillation lasts for longer than 48 hours, anticoagulation therapy will be needed for 3-4 weeks before the cardioversion and for weeks after as well. If drugs or cardioversion do not work, radiofrequency catheter ablation and the Maze procedure would be expected as further options.

Patient Sallie Mae Fisher was released from the hospital last Saturday. This patient is eighty two years old and lives alone as her daughter lives too far away to be helpful. Her medical history includes chronic congestive heart failure (CHF), atrial fibrillation (AF), and hypertension (HTN). She has been hospitalized four times for CHF exacerbation in the last six months. She was discharged from the hospital after being there three day to treat increased dyspnea, an eight pound weight gain, and chest pain. This paper will identify, prioritize, and describe at least four problems with evidence for each problem and identify at least four medical or nursing interventions with rationale for the interventions included.

What is atrial fibrillation? Atrial fibrillation, also known as afib, is an irregular heartbeat that produces disorganized electrical signals within the heart. This results in quivering of the atria, or top chambers of the heart which allows blood to pool. Stagnant blood in the atria increases the risk of developing a blood clot.1 The blood clot can enter the bloodstream and travel to the brain resulting in a stroke. Atrial fibrillation is associated with a 5 times increased risk for stroke, and approximately 15-20 percent of people who experience a stroke have atrial fibrillation.2 Symptoms of atrial fibrillation are heart palpitations, shortness of breath, weakness, chest pain, dizziness, nausea, and fatigue.1(p6) The incidence of afib increases

Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P

When one begins to discuss issues that arise with an intrinsic organ, things get serious. Unfortunately, vital organs like the heart and liver that are causing problems can’t be removed like the appendix or the kidney and “cure” people of issues such as Appendicitis or constant dealings with gallstones. This is true when things begin to go awry within the heart and conditions begin to arise. Atrial Fibrillation (A-fib) is the most common type of arrhythmia, or issue with the heart rate or rhythm. Though A-fib is not a condition that is life-threatening, depending on the severity and lack of treatment, this condition leads to more serious issues like heart disease, and even heart attacks and strokes, which are usually what end up being the cause of death in individuals diagnosed with the condition. Because of A-fib leading to other more detrimental problems, such as the ones listed above, it is difficult to identify and pinpoint if someone has it or had it, which is why it is known as one of the contributors to the “silent killer,” also known as the heart attack. In this paper, gaining a deeper understanding of Atrial Fibrillation will be accomplished through the exploration of: causes, diagnosis, symptoms and treatment, the variation of types, what all is affected within the body as a result, what happens physically, and what occurs at the cellular level when diagnosed with this disorder. All in all, Atrial Fibrillation should be taken seriously and further research is

Some key observations that we found throughout these clinical reports are that patients are offered numerous treatment options when diagnosed with heart failure. However, these treatment options are often restricted due to comorbid disorders/diseased the patients

Atrial fibrillation can cause significant discomfort (particularly if one has a lot of symptoms) and this may reduce one’s ability to exercise and do daily activities which may affect one’s life. Alternative, atrial fibrillation may not affect one’s day-to-day life. Atrial fibrillation is associated with a decrease in the heart’s ability to pump blood (it can result in the development of heart failure), which can affect one’s quality of life, increase the likelihood of being admitted to hospital and reduce one’s life expectancy. Atrial fibrillation itself does not pose a direct and immediate risk of death and many patients live with the arrhythmia for decades. However, atrial fibrillation can lead to serious complications. These possible complications

Atrial fibrillation is an important side effect with ivabradine with a recent meta-analysis showing a 15% increase in its incidence with the use of Ivabradine (37). Another combined analysis of SHIFT trial and BEAUTIFUL study reported an increase in atrial fibrillation incidence in this population with a number needed to harm of 58 (38). A proposed mechanism of Ivabradine leading to atrial fibrillation is genetic polymorphisms in HCN4 receptors causing an enhanced effect of ivabradine (39). As mentioned above, HCN4 receptors are found not only in the SA node but also AV node and individuals with genetic polymorphisms of HCN4 can have significant inhibition of the two primary pacemakers tissues of the heart. This provides substrate for atrial tissue to discharge and convert rhythm into atrial fibrillation.

I would like to express many thanks for my advisor Daryl Sieg for all of the support. I would also like to thank Dr. Klug for her guidance in the statistical aspect of this paper. Thank you to Allison Frank at the coagulation clinic in Fargo for taking the time to discuss my paper with me. Her view on these medications was very beneficial.

Today millions of Americans live or have lived with Atrial fibrillation. The main concern with this health issue is that many people who lived with it sometimes are not aware of it. Atrial fibrillation is defined by Mayo Clinic (2012) as “an irregular and often rapid heart rate that commonly causes poor blood flow to the body”. It occurs when the four chambers of the heart have a disrupted rhythm. The abnormal functionality of health may lead to a stroke because of the possible blood clot that will be formed. The Atrial fibrillation or Afib put the body in a situation without oxygen and nutrients because the body is not well supplied by a heart that is became weak. In general, only few people will feel change in their heartbeat. They may verbalize

Robert is a ninety-year-old man, who has been experiencing progressive and worsening heart failure. He has a long cardiac history and has been under the care of a cardiologist for the past 30 years. His medical history includes, hypertension, osteoarthritis, dyslipidemia and heart disease. Robert lives in a senior condominium community with his wife Janet.

Prevalence, age distribution, and gender of patients with atrial fibrillation: analysis and implications. Arch Intern Med. 1995; 155:469-73.

Cardiac catheterization is often referred to as coronary angiography or a coronary angiogram. It is a radiographic procedure that is used to look at and visualize the heart and the coronary arteries. During a cardiac catheterization it is possible for the cardiologist performing the procedure to see how effectively blood is flowing through the coronary arteries. In addition, this procedure allows the cardiologists to see how blood is moving through the chambers of the heart and how effective the heart valves are functioning. A cardiac catheterization can also allow for the visualization of the movement of the walls of the heart to see if the pumping action of the heart is normal.

According from the website www.nhlbi.nih.gov, AED stands for “an automated external defibrillator (AED). It’s a portable device that checks the heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm” AEDs are used on a person who is having a sudden cardiac arrest to save a person’s life. Many cardiac arrests happen at home, so having AED at home can help reviving a person with ventricular fibrillation. But critics argue there's no reliable evidence that home defibrillators save more lives. Critics also fear that people won't call for emergency medical services at all or quickly enough, that they won't maintain their AED properly, or that they'll forget where it is. To those people have a history of cardiac