Those with atrial fibrillation have a high prevalence
of anxiety and depression caused by the symptoms
they experience thus resulting in a decreased quality
of life (Gehi et al., 2012).
Shortness of breath
Atrial Fibrillation may be
asymptomatic in some
patients (Medical
Advisory Secretariat,
2006)
Symptoms include decreased limp temperature, increased
core temperature, decreased urine output, and mottled
skin colour (Cuadrado, 2002).
Radial pulse is lower than
apical pulse (Lippincott,
2011).
Abnormal ECG findings
(Lippincott, 2011)
Atrial activity is no longer represented by P waves but by
fibrillatory waves (f waves). This rhythm may be either
sustained or paroxysmal (occurring in bursts).
Irregular pulse rhythm
Undetectable atrial heart
rate
Ventricular heart rate around 130 beats per
minute
PQR - undetectable
T wave -
undetectable
QT - unmeasurable
QRS complex - 0.08 second
The first figure shows a healthy ECG
record. The second figure shows an ECG
with atrial fibrillation (Queiroz, Junior,
Lucena, & Barros, 2018).
Diagnostic Testing
Complications
Patients with may also experience increased
morbidity and mortality from complications such as
heart failure, strokes, hemorrhagic and
thromboembolic complications, heart attacks and
cardiovascular death (Jankowska-Polańska, Kaczan,
Lomper, Nowakowski, & Dudek, 2018; Mogensen et
al., 2017).
Roughly 44% of those with one of
the three types of atrial fibrillation
had a stroke.
Approximately 43% of those with any of the types of
atrial fibrillation have been hospitalized for heart failure
at some point.
Around 69% of the deaths of those with atrial
fibrillation was due to a heart attack or other
sudden cardiovascular event.
Cardiac ablation involves using a probe with an electrode at the tip on cardiac tissue with
the goal of scarring the area to prevent an electrical current from being conducted through
the area.
Types
Segmental Pulmonary Vein Ablation: the
pulmonary vein is isolated from the left
atrium by applying lesions at the ostial
region of the pulmonary veins.
Circumferential pulmonary vein ablation: surrounds the
pulmonary veins in linear lesions on the left atrial
myocardium outside the pulmonary vein ostia.
Catheter ablation is the procedure in which cardiac ablation is performed. It involves precisely
inserting a catheter through the femoral vein to access the heart in order to perform the ablation
procedure
Pharmacotherapy
Heart Rate Control. In order for heart rate
to be considered controlled it must meet
three goals: controlled at rest, controlled
during activity, and regularization of the
heart rate (Natale & Jalife, 2008).
Diltiazem or verapamil should be used as the preferred method over digoxin when using
pharmacotherapy in controlling heart rate as it has a better effect on the control of heart rate
during activity. Diltiazem or verapamil both have a rapid onset of action; this is especially
important in acute situations. β-blockers are the best at controlling heart rate with activity.
Atenolol, metoprolol, pindolol, and nadolol are all effective at controlling heart rates at rest and
with exertion.