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Atrial Fibrillation and Atrial Flutter

Bianca Lee, DO, MS and Youhua Zhang, MD, PhD Reviewed 06/2020
 


BASICS

This topic covers both atrial fibrillation (AFib) and atrial flutter (AFlut). 

DESCRIPTION

  • AFib: paroxysmal or continuous supraventricular tachyarrhythmia characterized by rapid, uncoordinated at...

DIAGNOSIS

HISTORY

Symptoms vary from none to mild (palpitations, light-headedness, fatigue, poor exercise capacity) to severe (angina, dyspnea, syncope). 

PHYSICAL EXAM

  • AFib: irregularly irregular heart ...

TREATMENT

MEDICATION

  • Two primary issues in the management of AFib and/or AFlut: decisions on heart rate control (control ventricular rate while allowing AFib to continue) or rhythm control (terminate A...

ONGOING CARE

Consider elective expert consultation 

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Adequate anticoagulation levels with warfarin should be determined weekly during initiation and monthly wh...

REFERENCES

1
Jonas DE, Kahwati LC, Yun JDY, et al. Screening for atrial fibrillation with electrocardiography: evidence report and systematic review for the US Preventive Services Task Force. JAMA. ...

CODES

ICD10

  • I48.91 Unspecified atrial fibrillation

  • I48.92 Unspecified atrial flutter

  • I48.0 Paroxysmal atrial fibrillation

  • I48.4 Atypical atrial flutter

  • I48.1 Persistent atrial fibrillation

  • I48.3 Typical atr...

CLINICAL PEARLS

  • Younger patients do better with a rhythm control strategy, older patients often do well with rate control.

  • Whether to anticoagulate or not is based on risk of thromboembolism regardless...

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