Literature Review On Atrial Fibrillation

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.

✽ Instructor Note: You could tell the students that the most frequent side effect of ACE inhibitors

- 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.

Most physicians and people who acquired the problem usually know it as A-FIB, a shorter term for atrial fibrillation. Atrial fibrillation deals with the cardiovascular system, in particular, the heart in the body. It is defined as, “the electrical signals that control this system are off-kilter. Instead of working together the atria do their own thing, causing fast fluttering heartbeat, also known as arrhythmia” (WEBMD). In a normal pumping blood of the heart the atria would squeeze first, followed by the ventricles of the heart. A-fib can be a serious issue if not treated, due to the inadequate pumping of the blood, causing a higher chance of heart failure. It is also a higher chance in getting a stroke, because improper flow of the blood can cause clots in the

daily. She is also on metoprolol tartrate 25 mg half tablet b.i.d. She cannot tolerate ACE inhibitors or ARB secondary to angioedema in the past. The patient was started on metoprolol after an episode of ventricular tachycardia with ectopy for which she was hospitalized. She does see David Cunningham

43 percent of alarm conditions indicated non-critical, and “generally non-actionable,” events; 38 percent of alarm conditions indicated premature ventricular complexes (PVCs), which, since a landmark 1988 Cardiac Arrhythmic Suppression Trial (CAST) study, are no longer treated; and 3.6 percent of alarm

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

The second step in managing patients with CHF is using evidence-based treatment options. Beta-blockers have proven to be effective at increasing left ventricular function; however, the majority of patients are not receiving adequate dosages of the medication. According to Driscoll et al

Radio Frequency Cardiac Ablation Therapy as First Line Treatment for Paroxysmal Atrial Fibrillation vs. Anti-Arrhythmic Drug Therapy.

It is important to educate the patient about the side effects of each medication. Because most patients with atrial fibrillation are sent home on anticoagulants it is important to teach the signs and symptoms of bleeding, and to make sure they understand how vital it is to have lab work drawn because the dosage of the medication may need to be adjusted depending on the results. It is very important the patient understands not to use any aspirin products. Patients should understand the importance of follow up visits, so that the physician can continuously monitor their heart

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

5. Based on this study, apixaban is superior to warfarin, but why in the clinical setting, warfarin is still the first line medication to be used in atrial fibrillation patients?

Without early intervention on average 360,000 people out of the hospital succumb to cardiac arrest. “ Cardiac arrest and sudden death account for 60 percent of all deaths from coronary artery disease”,(Bledsoe, Porter, & Cherry, 2011,2007,2004, p. 1229)There are several causes of sudden cardiac arrest. Most are caused by ventricular fibrillation. “During ventricular fibrillation, the ventricles do not beat normally. Instead they quiver rapidly and irregularly.” When this occurs, the heart pumps very little and blood does not get circulated throughout the body. “ Most of the cases found with sudden cardiac death are related to undetected cardiovascular disease.("Sudden Cardiac Death," 2015, para. 2)Sudden cardiac arrest are immediate and drastic that includes sudden collapse, no pulse, not breathing, and loss of consciousness. “Four rhythms produce pulseless cardiac arrest: ventricular fibrillation, rapid ventricular tachycardia, pulseless electrical activity and asystole.”("Circulation ," 2005, p. IV-58)Other signs and symptoms that could occur prior to sudden cardiac arrest, include fatigue,