User:Mr. Ibrahem/Atrial fibrillation

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Atrial fibrillation
Other namesAuricular fibrillation[1]
Leads V4 and V5 of an electrocardiogram showing atrial fibrillation with somewhat irregular intervals between heart beats, no P waves, and a heart rate of about 150 beats per minute.
SpecialtyCardiology
SymptomsNone, heart palpitations, fainting, shortness of breath, chest pain[2][3]
ComplicationsHeart failure, dementia, stroke[3]
Usual onset> age 50[4]
Risk factorsHigh blood pressure, valvular heart disease, coronary artery disease, cardiomyopathy, congenital heart disease, COPD, obesity, smoking, sleep apnea[3][5][6][7]
Diagnostic methodFeeling the pulse, electrocardiogram[8]
Differential diagnosisIrregular heartbeat[9]
TreatmentLifestyle modifications, rate control, rhythm control, anticoagulation[5]
Frequency2.5% (developed world), 0.5% (developing world)[4]
Deaths193,300 with atrial flutter (2015)[10]

Atrial fibrillation (AF or A-fib) is an abnormal heart rhythm (arrhythmia) characterized by the rapid and irregular beating of the atrial chambers of the heart.[11] It often begins as short periods of abnormal beating, which become longer or continuous over time.[4] It may also start as other forms of arrhythmia such as atrial flutter that then transform into AF.[12] Often episodes have no symptoms.[3] Occasionally there may be heart palpitations, fainting, lightheadedness, shortness of breath, or chest pain.[2] The disease is associated with an increased risk of heart failure, dementia, and stroke.[3] It is a type of supraventricular tachycardia.[13]

High blood pressure and valvular heart disease are the most common alterable risk factors for AF.[5][6] Other heart-related risk factors include heart failure, coronary artery disease, cardiomyopathy, and congenital heart disease.[5] In the developing world, valvular heart disease often occurs as a result of rheumatic fever.[14] Lung-related risk factors include COPD, obesity, and sleep apnea.[3] Other factors include excess alcohol intake, tobacco smoking, diabetes mellitus, and thyrotoxicosis.[3][7][14] However, half of the cases are not associated with any of these risks.[3] Healthcare professionals may suspect AF by feeling the pulse and confirm the diagnosis by interpreting an electrocardiogram (ECG).[8] A typical ECG in AF shows no P waves and an irregular ventricular rate.[8]

Healthy lifestyle changes, such as weight loss in people with obesity, increased physical activity, and drinking less alcohol, can lower the risk for atrial fibrillation and reduce its burden if it occurs.[15] AF is often treated with medications to slow the heart rate to a near-normal range (known as rate control) or to convert the rhythm to normal sinus rhythm (known as rhythm control).[5] Electrical cardioversion can convert AF to normal heart rhythm and is often necessary for emergent use if the person is unstable.[16] Ablation may prevent recurrence in some people.[17] For those at low risk of stroke, AF does not necessarily require blood-thinning though some healthcare providers may prescribe aspirin or an anti-clotting medication.[18] For those at more than low risk, experts generally recommend an anti-clotting medication.[18] Anti-clotting medications include warfarin and direct oral anticoagulants.[18] Most people are at higher risk of stroke.[19] While these medications reduce stroke risk, they increase rates of major bleeding.[20]

Atrial fibrillation is the most common serious abnormal heart rhythm and, as of 2020, affects more than 33 million people worldwide.[3][15] As of 2014, it affected about 2 to 3% of the population of Europe and North America.[4] This was an increase from 0.4 to 1% of the population around 2005.[21] In the developing world, about 0.6% of males and 0.4% of females are affected.[4] The percentage of people with AF increases with age with 0.1% under 50 years old, 4% between 60 and 70 years old, and 14% over 80 years old being affected.[4] A-fib and atrial flutter resulted in 193,300 deaths in 2015, up from 29,000 in 1990.[10][22] The first known report of an irregular pulse was by Jean-Baptiste de Sénac in 1749.[3] Thomas Lewis was the first doctor to document this by ECG in 1909.[3]

References[edit]

  1. ^ "Atrial fibrillation or flutter: MedlinePlus Medical Encyclopedia". medlineplus.gov. Archived from the original on 9 June 2019. Retrieved 28 May 2019.
  2. ^ a b Gray, David (2010). Chamberlain's Symptoms and Signs in Clinical Medicine: An Introduction to Medical Diagnosis (13th ed.). London: Hodder Arnold. pp. 70–71. ISBN 9780340974254.
  3. ^ a b c d e f g h i j k Munger, TM; Wu, LQ; Shen, WK (January 2014). "Atrial fibrillation". Journal of Biomedical Research. 28 (1): 1–17. doi:10.7555/JBR.28.20130191. PMC 3904170. PMID 24474959.
  4. ^ a b c d e f Zoni-Berisso, M; Lercari, F; Carazza, T; Domenicucci, S (2014). "Epidemiology of atrial fibrillation: European perspective". Clinical Epidemiology. 6: 213–20. doi:10.2147/CLEP.S47385. PMC 4064952. PMID 24966695.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  5. ^ a b c d e Anumonwo, JM; Kalifa, J (November 2014). "Risk Factors and Genetics of Atrial Fibrillation". Cardiology Clinics. 32 (4): 485–94. doi:10.1016/j.ccl.2014.07.007. PMID 25443231.
  6. ^ a b Nguyen, TN; Hilmer, SN; Cumming, RG (10 September 2013). "Review of epidemiology and management of atrial fibrillation in developing countries". International Journal of Cardiology. 167 (6): 2412–20. doi:10.1016/j.ijcard.2013.01.184. PMID 23453870.
  7. ^ a b Staerk, L; Sherer, JA; Ko, D; Benjamin, EJ; Helm, RH (April 2017). "Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes". Circulation Research (Review). 120 (9): 1501–17. doi:10.1161/CIRCRESAHA.117.309732. PMC 5500874. PMID 28450367.
  8. ^ a b c Ferguson C, Inglis SC, Newton PJ, Middleton S, Macdonald PS, Davidson PM (2013). "Atrial fibrillation: stroke prevention in focus". ACC. 27 (2): 92–98. doi:10.1016/j.aucc.2013.08.002. PMID 24054541.
  9. ^ Hui, David; Leung, Alexander A.; Padwal, Raj (2015). Approach to Internal Medicine: A Resource Book for Clinical Practice. Springer. p. 45. ISBN 9783319118215. Archived from the original on 8 September 2017.
  10. ^ a b GBD 2015 Mortality and Causes of Death, Collaborators. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281. {{cite journal}}: |first1= has generic name (help)CS1 maint: numeric names: authors list (link)
  11. ^ "Heart Disease Other Related Conditions". cdc.gov. 3 September 2014. Archived from the original on 14 February 2015. Retrieved 19 February 2015.
  12. ^ Bun, Sok-Sithikun; Latcu, Decebal Gabriel; Marchlinski, Francis; Saoudi, Nadir (2 April 2015). "Atrial flutter: more than just one of a kind". European Heart Journal. 36 (35). Oxford University Press (OUP): 2356–2363. doi:10.1093/eurheartj/ehv118. ISSN 0195-668X. PMID 25838435.
  13. ^ Richard D. Urman; Linda S. Aglio; Robert W. Lekowski, eds. (2015). Essential clinical anesthesia review : keywords, questions and answers for the boards. p. 480. ISBN 9781107681309. Archived from the original on 8 September 2017.
  14. ^ a b Mischke, K; Knackstedt, C; Marx, N; Vollmann, D (April 2013). "Insights into atrial fibrillation". Minerva Medica. 104 (2): 119–30. PMID 23514988.
  15. ^ a b Chung, MK; Eckhardt, LL; Chen, LY; Ahmed, HM; Gopinathannair, R; Joglar, JA; Noseworthy, PA; Pack, QR; Sanders, P; Trulock, KM; American Heart Association Electrocardiography and Arrhythmias Committee and Exercise Cardiac Rehabilitation, and Secondary Prevention; Committee of the Council on Clinical Cardiology; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Lifestyle and Cardiometabolic Health (March 2020). "Lifestyle and Risk Factor Modification for Reduction of Atrial Fibrillation: A Scientific Statement From the American Heart Association". Circulation. 141 (16): e1-23. doi:10.1161/CIR.0000000000000748. PMID 32148086.
  16. ^ Oishi, ML; Xing, S (February 2013). "Atrial fibrillation: management strategies in the emergency department". Emergency Medicine Practice. 15 (2): 1–26, quiz 27. PMID 23369365.
  17. ^ Amerena, JV; Walters, TE; Mirzaee, S; Kalman, JM (4 November 2013). "Update on the management of atrial fibrillation". The Medical Journal of Australia. 199 (9): 592–97. doi:10.5694/mja13.10191. PMID 24182224.
  18. ^ a b c Freedman, B; Potpara, TS; Lip, GY (20 August 2016). "Stroke prevention in atrial fibrillation". Lancet. 388 (10046): 806–17. doi:10.1016/S0140-6736(16)31257-0. PMID 27560276. S2CID 5578741.
  19. ^ Kirchhof, Paulus; Benussi, Stefano (27 August 2016). "2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS". European Heart Journal. 37 (38): 2893–962. doi:10.1093/eurheartj/ehw210. PMID 27567408.
  20. ^ Steinberg, BA; Piccini, JP (14 April 2014). "Anticoagulation in atrial fibrillation". BMJ (Clinical Research Ed.). 348: g2116. doi:10.1136/bmj.g2116. PMC 4688652. PMID 24733535.
  21. ^ Fuster, Valentin (2006). "ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: 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 (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society". Circulation. 114 (7): e257–354. doi:10.1161/CIRCULATIONAHA.106.177292. PMID 16908781.
  22. ^ GBD 2013 Mortality and Causes of Death, Collaborators (17 December 2014). "Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013". Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2. PMC 4340604. PMID 25530442. {{cite journal}}: |first1= has generic name (help)CS1 maint: numeric names: authors list (link)
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