Majority of patients will not present with any symptoms at all. Only mild palpitations, chest discomfort, light headedness, dyspnea, and generalized weakness are subjectively felt by the patients. Upon physical examinations, pulses and auscultatory findings will reveal an irregularly regular rhythm. Pulses may not coincide with ventricular rates because the pumping may not generate sufficient blood or force to produce peripheral pressure.

• Weakness

  Protective factors were a history of diabetes mellitus (weak association) and the presence of a urinary tract infection (weak association). [ncbi.nlm.nih.gov]

  This usually presents as palpitations, dyspnea, dizziness, fatigue, and weakness among afflicted patients. The irregular atrial rhythm in atrial fibrillation raises the risk for embolic stroke among susceptible patients. [symptoma.com]

• Fatigue

  Treating AF may prevent stroke, fatigue, and heart failure. Find a specialist who can determine if your symptoms are a result of atrial fibrillation. Causes The causes of AF are often unclear. [medtronic.com]

  Symptoms include irregular pulse, palpitations, shortness of breath and fatigue. Inova offers leading expertise in all aspects of atrial fibrillation management. [inovaheart.org]

  But you may feel Palpitations -- an abnormal rapid heartbeat Shortness of breath Weakness or difficulty exercising Chest pain Dizziness or fainting Fatigue Confusion AF can lead to an increased risk of stroke. [medlineplus.gov]

  The primary symptoms of atrial fibrillation include racing heart rates, an irregular feeling of heart beats, fatigue, shortness of breath, mild chest tightness, and lightheadedness. [pathnetwork.org]

• Malaise

  If symptoms occur, they may include: sensations of a ‘fluttering’ heartbeat (palpitations) irregular heartbeat (detected by checking the pulse) angina (chest pains) general malaise dizziness inability to tolerate exercise fainting spells. [betterhealth.vic.gov.au]

  Reduce dose with hepatic impairment and start with smaller dose in renal impairment. 90-360 mg QD (ER)  Verapamil 0.075-0.15 mg/kg IV bolus over 2 minutes, then 5 mcg/kg/min 40-120 mg TID Dizziness, malaise, lethargy, headache, hot flushes, gastrointestinal [ekjm.org]

• Dyspnea

  This usually presents as palpitations, dyspnea, dizziness, fatigue, and weakness among afflicted patients. The irregular atrial rhythm in atrial fibrillation raises the risk for embolic stroke among susceptible patients. [symptoma.com]

  He developed pronounced dyspnea on exertion, and repeated ECGs and another Holter monitor now showed persistent AF. [doi.org]

  Shortness of breath Other names Dyspnea, dyspnoea, breathlessness, difficulty of breathing, respiratory distress Pronunciation Dyspnea: /dɪspˈniːə/ Specialty Pulmonology Shortness of breath (SOB), also known as dyspnea, is a feeling of not being able [en.wikipedia.org]

  Symptoms include palpitations and sometimes weakness, effort intolerance, dyspnea, and presyncope. Atrial thrombi may form, causing a significant risk of embolic stroke. Diagnosis is by electrocardiography. [msdmanuals.com]

  Third, although the rates of incident HF during follow-up in patients with and without diabetes were similar, it is noteworthy that dyspnea, exercise intolerance, and fatigue, symptoms often due to HF, were reported approximately 10% more frequently by [onlinejacc.org]

• Exertional Dyspnea

  dyspnea, fatigue, weakness, and tachycardia.[15] It may lead to heart failure.[15] Anaemia is often a cause of dyspnea. [en.wikipedia.org]

• Nausea

  We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. [ncbi.nlm.nih.gov]

  While taking anticoagulants, make sure the doctor knows about any planned or existing pregnancy or any signs of bleeding, such as: very large bruises nausea and light-headedness vomiting blood coughing up blood unusually heavy menstrual flow gums that [medicalnewstoday.com]

  Medications may include: Dofetilide Flecainide Propafenone Amiodarone Sotalol Although these drugs may help maintain a normal heart rhythm, they can cause side effects, including: Nausea Dizziness Fatigue Rarely, they may cause ventricular arrhythmias [mayoclinic.org]

  Some include: palpitations (a sensation of rapid and irregular heart beat), dizziness or lightheadedness, weak feeling, shortness of breath, chest pain and/or angina, nausea. [emedicinehealth.com]

• Heart Disease

  The most common causes of AF are coronary heart disease, hypertension, valvular heart disease and hyperthyroidism. [patient.info]

  The most common conditions associated with AF were hypertension (10.3%-71.9%) and valvular heart disease (5.6%-66.3%). The prevalence of stroke in patients with AF ranged from 6.7% to 27%. [ncbi.nlm.nih.gov]

• Palpitations

  He correlated gross irregularities (palpitation) with necropsy observation of mitral valve disease and dilatation of the left ventricle. [ncbi.nlm.nih.gov]

  This usually presents as palpitations, dyspnea, dizziness, fatigue, and weakness among afflicted patients. The irregular atrial rhythm in atrial fibrillation raises the risk for embolic stroke among susceptible patients. [symptoma.com]

  Atrial fibrillation, known as AF or Afib, is an irregular, rapid heart rate that may cause symptoms like heart palpitations, fatigue, and shortness of breath. AF occurs when the upper chambers of the heart (atria) beat out of rhythm. [medtronic.com]

• Tachycardia

  Circumferential pulmonary vein isolation and circumferential SVC isolation resulted in termination of tachycardia. [ncbi.nlm.nih.gov]

  There are three major types of tachycardia: Atrial tachycardia (starting in the atria) Supraventricular tachycardia (starting above the ventricles) Ventricular tachycardia (starting in the ventricles) Bradycardia refers to a slow heart rhythm, caused [columbiasurgery.org]

  Instead of intermittently contracting, the atria quiver continuously in a chaotic pattern, causing a totally irregular, often tachycardia ventricular rate. [icd9data.com]

  Most people think of tachycardia as a supraventricular tachycardia, but there are many other forms of tachycardia. [uihc.org]

• Chest Pain

  In many patients, it can also cause chest pain, heart attack, or heart failure. [icd9data.com]

  If you have chest pain, seek emergency medical assistance immediately. Chest pain could signal that you're having a heart attack. [mayoclinic.org]

  One hour later, the patient complained of chest pain in combination with marked ST-segment elevation in the anterior leads. [ncbi.nlm.nih.gov]

• Irregular Heart Rhythm

  Published on Feb 18, 2020 This small device may change how doctors identify and manage patients with atrial fibrillation  an irregular heart rhythm that increases risk of stroke. And the past. [youtube.com]

  While an irregular heart beat can occur independent of any other heart condition, it is worth having the problem checked out because an irregular heart rhythm may be a sign of a concerning underlying heart condition. [uihc.org]

  This irregular heart rhythm can lead to congestive heart failure and stroke. Symptoms include irregular pulse, palpitations, shortness of breath and fatigue. Inova offers leading expertise in all aspects of atrial fibrillation management. [inovaheart.org]

  What Happens With AFib Atrial fibrillation is a fast and very irregular heart rhythm caused by extremely rapid and chaotic electrical impulses originating in the heart's atria (the two upper cardiac chambers). [verywellhealth.com]

• Stroke

  The decrease in the rate of all stroke was due to a large decrease in ischemic stroke with only a small absolute increase in hemorrhagic stroke. Of all ischemic strokes, 12.5% were lethal. [dx.doi.org]

  Admitting acute ischemic stroke patients to a stroke care monitoring unit versus a conventional stroke unit: a randomized pilot study. Stroke. 2003 ; 34 :101–104. Link Google Scholar 19. Bansil S, Karim H. [doi.org]

  Edoxaban is most likely similar to warfarin in preventing stroke or systemic embolism and also most likely has less risk for major bleeding and hemorrhagic stroke than warfarin. [effectivehealthcare.ahrq.gov]

  Strokes related to AF are associated with higher mortality, greater disability, longer hospital stays, and lower chance of being discharged home than strokes unrelated to AF. [ncbi.nlm.nih.gov]

• Dizziness

  We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. [ncbi.nlm.nih.gov]

  This usually presents as palpitations, dyspnea, dizziness, fatigue, and weakness among afflicted patients. The irregular atrial rhythm in atrial fibrillation raises the risk for embolic stroke among susceptible patients. [symptoma.com]

  But you may feel Palpitations -- an abnormal rapid heartbeat Shortness of breath Weakness or difficulty exercising Chest pain Dizziness or fainting Fatigue Confusion AF can lead to an increased risk of stroke. [medlineplus.gov]

  This can cause problems including dizziness, shortness of breath and tiredness. [nhs.uk]

• Confusion

  But you may feel Palpitations -- an abnormal rapid heartbeat Shortness of breath Weakness or difficulty exercising Chest pain Dizziness or fainting Fatigue Confusion AF can lead to an increased risk of stroke. [medlineplus.gov]

  But you may feel palpitations -- an abnormal rapid heartbeat shortness of breath weakness or difficulty exercising chest pain dizziness or fainting fatigue confusion af can lead to an increased risk of stroke. [icd9data.com]

  Heart palpitations Lack of energy Lightheadedness Confusion Chest discomfort Shortness of breath, even at rest Yes. When it becomes constant, you may need treatment. [lifelinescreening.com]

  Symptoms may include: Pulse that feels rapid, racing, pounding, fluttering, irregular, or too slow Sensation of feeling the heart beat ( palpitations ) Confusion Dizziness, lightheadedness Fainting Fatigue Loss of ability to exercise Shortness of breath [nlm.nih.gov]

• Somnolence

  We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. [ncbi.nlm.nih.gov]

Atrial fibrillations are effectively diagnosed by an accurate medical history and a thorough physical examination. The following diagnostic methods and tests may be implored in patients presenting signs and symptoms of atrial fibrillations:

• Electrocardiogram (ECG) is considered the primary tool in diagnosing atrial fibrillations. 
• Holter monitor monitors a 24 hour period of cardiac electrical activity to detect intermittent AF cases.
• Event recorder will record cardiac activities in a period of weeks to months. It comes with an access button that the patient could easily press during an event or period of chest discomfort or irregularity for real time recording of the dysrhythmia. 
• Echocardiography elucidates the heart structures and clot formations during atrial fibrillation events [9].
• Blood tests will determine the presence of electrolyte imbalance and hormonal hyperactivity like hyperthyroidism that can cause clinical dysrhythmias like AF.
• Chest radiography will demonstrate other anatomic pathology of the heart, pericardium, and the lungs that may induce atrial fibrillation.

• Narrow QRS Complex

  On an ECG (EKG), atrial fibrillation is characterized by absence of P-waves and irregular narrow QRS complexes. Reminder: P-wave represents electrical activity of the SA node that is now obscured by activities of multiple ectopic sites. [youtube.com]

• Inferior Q Wave

  She is in sinus rhythm when she presents, with an electrocardiogram demonstrating inferior Q-waves, but a Holter monitor confirms paroxysmal atrial fibrillation (AF). [doi.org]

• Atrioventricular Dissociation

  After establishment of a stable perfused-heart preparation, the posterior atria were cut away to expose the left and right atrial endocardium, and the atrioventricular node was mechanically crushed, resulting in atrioventricular dissociation. [dx.doi.org]

• Absent A-Waves

  P waves if arrhythmia is not captured on ECG then Holter monitoring in the outpatient setting these patients are hemodynamically stable telemitry in the inpatient setting Transthoracic echocardiogram (TTE) can assess atrial size and ventricular function [medbullets.com]

• Abnormal ECG

  At the same time, the harms of diagnostic follow-up and treatment prompted by abnormal ECG results are well established and include misdiagnosis and invasive testing. [ncbi.nlm.nih.gov]

  But the paper notes that abnormal ECGs were sent to a cardiologist for review, and also says that the Kardia produced some false positives (indications of AFib that the reviewing cardiologists found to be false). [spectrum.ieee.org]

The general treatment goals involved in the control of atrial fibrillation include the resetting of the heart rate and rhythm, and the active prevention of blood clot formation. Conservative approaches to atrial fibrillation using medications to control rhythm is primarily sought before invasive procedures are implored. Some patients presenting with an organic disease like hyperthyroidism that induces atrial fibrillation may be treated accordingly to relieve the heart of these unnecessary stresses.

To reset the heart to normal rhythm, physicians often resort to cardioversion of the heart which may done by either electrical means (Electrical cardioversion), and by medical cardioversion. When the abnormal rhythm is normalized after electrical cardioversion, patients are often given antiarrhythmic drugs like flecainide, propafenone, dofetilide, and amiodarone to prevent the recurrence of the atrial dysrhythmia. Medications to control resting heart rate may be given like digoxin, beta blockers, and calcium channel blockers although proper precautions must be made to prevent hypotension [10].

In cases, where medical cardioversion fails to achieve its goals, surgical approaches like cardiac catheter ablation, atrio-ventricular node (AV node) ablation, and surgical maze procedures may be the only options left. Patients with atrial fibrillation are at high risk for the development of thrombi and embolus from blood clots; thus, anticoagulation therapy like warfarin, dabigatran, rivaroxaban, and apixaban may be given as a preventive measure.

Atrial fibrillation is closely associated with thromboembolic events that is why patients with AF have up to 1.9 fold risk of death compared to those who don’t suffer from it [6]. Mild asymptomatic AF has a good long term prognosis. The administration of maintenance medications like rate control and anticoagulants does not increase the survival rating of AF patients that are asymptomatic [7].

The risk of a thromboembolic stroke among AF patients beyond 75 years of age is staggering; thus, anticoagulant therapy is perpetually given unless other contraindications are identified. Meta-analysis data revealed that patients who were brought to the emergency room with myocardial infarction presenting with AF have a 40% increase in mortality rate [8].

Atrial fibrillation may be induced by any of these conditions:

• Coronary artery disease (CAD)
• History of heart surgery
• Viral endocarditis
• Sick sinus syndrome
• Sleep apnea
• Pneumonia and other lung diseases
• Stimulants like coffee, tobacco, alcohol and medications
• Hyperthyroidism
• Electrolyte imbalance
• Heart valve abnormalities
• Congenital heart disease
• Neurologic disorders
• Carditis and pericarditis
• Genetic factors

In the United States alone, more than 2.2 million Americans are suffering from atrial fibrillation. This cardiac dysfunction is primarily age related, because a fourth of the patients beyond 40 years old are at risk of developing atrial fibrillation in their remaining lifetime [2].

The increasing prevalence of atrial fibrillation among the elderly population is expected to double by 2050 in the US. Atrial fibrillation is relatively rare in infants and childhood, except for those who have undergone prior cardiac surgery [3]. Atrial fibrillation is more common among males than in females, and it is commonly seen in the white race than the black. Patients reaching the seventh decade the prevalence doubles per 10 year increment [4].

Arial fibrillation is strongly associated with cardiovascular diseases like coronary artery diseases (CAD), congestive heart failure (CHF) and diabetes mellitus [5]. Although the exact mechanism is inconclusively elaborated, theories abound that excessive catecholamine, hemodynamic stress and cardiac inflammation causes the AF phenomenon. There are theories of the occurrence of an automatic focus of electrical conduction from sources other than the AV node like some focal regions in the pulmonary vein can cause the unsynchronized impulses that gives rise to AF.

The active prevention of heart diseases through a heart friendly diet, exercise, and lifestyle may prevent occurrence of an acquired atrial fibrillation. A healthy lifestyle connotes the willful avoidance of stimulants like caffeine, alcohol and tobacco. Regular exercises and physical activity to maintain ideal body weight is also paramount in the prevention of heart diseases. Patients must understand that severe anger and stress can directly cause heart rhythm dysfunction on a long term basis.

Atrial fibrillation (AF) is clinically defined as a fast and irregular heart rate that reduces blood flow all over the body. Although atrial fibrillation is not considered life-threatening, persistent symptoms may require immediate treatment to prevent serious complications.

The desynchronized atrial contraction in atrial fibrillation may lead to thrombi or emboli formation that can functionally obstruct blood flow in multiple distant organs and cause ischemia. Atrial fibrillation is often times approached by interventions and medications to normalize the cardiac electrical activities. Atrial fibrillation is classified into three patterns: Paroxysmal AF, persistent AF, and permanent AF [1].

Definition

Atrial fibrillation is clinically defined as a fast and irregular heart rate that reduces blood flow all over the body.

Cause

Atrial fibrillation may be triggered by an ongoing heart disease, metabolic disease, neurologic disorders, and the intake of stimulants.

Symptoms

Patients may be asymptomatic, or may complain of palpitation, dizziness and weakness.

Diagnosis

Electrocardiography, echocardiography, Holter monitoring, blood tests and a chest X-ray may be used to diagnose the condition.

Treatment and follow-up

Medical and electrical cardioversion, and cardiac surgery ablation are the most common treatment options.

1. Fuster V, Rydén LE, Asinger RW, et al. ACC/AHA/ESC Guidelines for the Management of Patients With Atrial Fibrillation: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology. Circulation. Oct 23 2001; 104(17):2118-50.
2. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. Aug 31 2004; 110(9):1042-6.
3. Abdel Latif A, Messinger-Rapport BJ. Should nursing home residents with atrial fibrillation be ant coagulated? Cleve Clin J Med. Jan 2004; 71(1):40-4.
4. Rathore SS, Berger AK, Weinfurt KP, Schulman KA, Oetgen WJ, Gersh BJ, et al. Acute myocardial infarction complicated by atrial fibrillation in the elderly: prevalence and outcomes. Circulation. Mar 7 2000; 101(9):969-74.
5. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. Oct 16 1998; 82(8A):2N-9N.
6. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. Aug 1991; 22(8):983-8.
7. Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. Dec 5 2002; 347(23):1825-33.
8. Jabre P, Roger VL, Murad MH, et al. Mortality associated with atrial fibrillation in patients with myocardial infarction: a systematic review and meta-analysis. Circulation. Apr 19 2011; 123(15):1587-93.
9. Klein AL, Grimm RA, Murray RD, Apperson-Hansen C, Asinger RW, Black IW, et al. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. N Engl J Med. May 10 2001; 344(19):1411-20.
10. Hagens VE, Ranchor AV, Van Sonderen E, Bosker HA, Kamp O, Tijssen JG, et al. Effect of rate or rhythm control on quality of life in persistent atrial fibrillation. Results from the Rate Control Versus Electrical Cardioversion (RACE) Study. J Am Coll Cardiol. Jan 21 2004; 43(2):241-7.