81. Understanding Atrial Fibrillation For many patients, a diagnosis of atrial fibrillation or Afib is frightening.To help you understand your condition and the options for treating it, http://www.healthsystem.virginia.edu/Internet/afibcenter/whatis_afib.cfm

[ Skip Navigation ] Health System Home For Health Answers Healthcare Professionals ... Advanced Search Health System Search Search for Information People UVa Home Health System News Health System Events (all) Health System Publications ... Site Index Site Search Search this site: Understanding Atrial Fibrillation For many patients, a diagnosis of atrial fibrillation or Afib is frightening. To help you understand your condition and the options for treating it, we have taken some commonly asked questions and provided answers to them. Please remember that this is general information. Your doctor or heart rhythm specialist that is treating you will be able to answer questions that you might have about your particular condition. What makes a normal heart beat? What is Atrial Fibrillation (Afib)? Who gets Afib? What causes Afib? ... Glossary of Terms What makes a normal heart beat? The heart is a large muscle with four chambers. There are two top chambers (left and right) called the atria and two bottom chambers (left and right) called the ventricles (see Figure 1). These chambers fill with blood from the body and then squeeze to circulate or deliver blood to other areas of the body, such as the lungs so that oxygen can be added, or oxygen filled blood to the rest of the body tissues. The heart muscle contracts after it is stimulated (or told to) by an electrical impulse. There is an area of special tissue in the right atrium called the SA node, which starts an electrical impulse that will eventually travel down the electrical tracts (

82. Treatment Of Atrial Fibrillation Treatment options for atrial fibrillation, including anticoagulation, rate control,rhythm control, antiarrhythmic meds, ablation, surgical, http://www.healthsystem.virginia.edu/Internet/afibcenter/treatment.cfm

[ Skip Navigation ] Health System Home For Health Answers Healthcare Professionals ... Advanced Search Health System Search Search for Information People UVa Home Health System News Health System Events (all) Health System Publications ... Site Index Site Search Search this site: Treatment of Atrial Fibrillation Anticoagulation Rate Control Rhythm Control Antiarrhythmic meds ... Device implants Anticoagulation One of the most important aspects of treating and management of atrial fibrillation is prevention of thromboembolic events. There is a strong association with stroke and atrial fibrillation. A number of studies have demonstrated a significant benefit of warfarin in patients with atrial fibrillation The goal of anticoagulation therapy with warfarin is to achieve an INR between 2.0 and 3.0. At values of greater than 4.0 there is an increase association of hemorrhagic complications. At values below 2.0 there is increased incidence of thromboembolic events. Therefore, a therapeutic range of between 2-3 is the appropriate target of most patients with atrial fibrillation. Therapies The treatment of atrial fibrillation should be individualized. There are two general strategies. One is allowing the patient to remain in atrial fibrillation but controlling the ventricular response with either AV nodal blocking agents or AV junction ablation. The second strategy is a rhythm control strategy either through antiarrhythmic medications or ablation.

83. Atrial Fibrillation (AF) - Patient UK atrial fibrillation causes a fast and erratic heart beat. It is a complicationof various diseases. Medication can slow the heart rate back to normal, http://www.patient.co.uk/showdoc/23068682/

Atrial Fibrillation (AF) Atrial fibrillation causes a fast and erratic heart beat. It is a complication of various diseases. Medication can slow the heart rate back to normal, and ease symptoms. You may also be advised to take warfarin to reduce the risk of a stroke. What is atrial fibrillation? Normally, the heart beats at a steady, regular rate. This is controlled by tiny electrical impulses which start from the Sino-Atrial node in the right atrium (a kind of 'timer' at the top of the heart). Each electrical impulse causes the heart muscle to contract and pump blood into the blood vessels (arteries) which go from the heart. Depending on age and fitness, a normal heart beats about 60-100 times per minute when at rest, but faster when you exercise. In atrial fibrillation (AF), the normal controlling 'timer' in the heart does not work. Many random electrical impulses then 'fire off' from the heart muscle in the atria. These cause the heartbeat to become much faster than normal. In addition, the normal regular rhythm is lost, and the heartbeat (and pulse) is erratic. How common is atrial fibrillation?

84. ► Atrial Fibrillation/flutter A medical encycopedia article on the topic atrial fibrillation/flutter. http://www.umm.edu/ency/article/000184.htm

var MenuLinkedBy='AllWebMenus [2]', awmBN='530'; awmAltUrl=''; Disease Nutrition Surgery Symptoms Injury ... Z Maryland Medical Center Programs Arrhythmia Service Maryland Heart Center Home Medical Reference ... Encyclopedia (English) Toggle English Spanish Atrial fibrillation/flutter Overview Symptoms Treatment Prevention Definition: Atrial fibrillation/flutter is a disorder of heart rhythm (arrthymia) usually with rapid heart rate in which the upper heart chambers (atria) are stimulated to contract in a very disorganized and abnormal manner. Alternative Names: Auricular fibrillation Causes, incidence, and risk factors: Arrhythmias are caused by a disruption of the normal functioning of the electrical conduction system of the heart. Normally, the atria and ventricles contract in a coordinated manner. In atrial fibrillation and flutter, the atria are stimulated to contract very quickly and differently from the normal activity originating from the sinoatrial node. This results in ineffective and uncoordinated contraction of the atria in atrial fibrillation, and in a peculiarly organized contraction pattern in atrial flutter. The condition can be caused by impulses which are transmitted to the ventricles in an irregular fashion or by some impulses failing to be transmitted. This makes the ventricles beat irregularly, which leads to an irregular (and usually fast) pulse in atrial fibrillation.

85. What Is Atrial Fibrillation? Information on atrial fibrillation and treatment options, including the Cryomazeprocedure. http://www.umm.edu/heart/af.html

var MenuLinkedBy='AllWebMenus [2]', awmBN='530'; awmAltUrl=''; Maryland Heart Center Request an Appointment About Us Virtual Tour ... Training Programs Related Resources Within UMM Artificial Organs Laboratory Translate using Google to Spanish German French Italian Portuguese What is Atrial Fibrillation? CryoMAZE Procedure CryoMAZE Home Atrial Fibrillation and Stroke CryoMAZE Frequently Asked Questions Video: Cardiac surgeon James Gammie discusses the latest advances in cardiac surgery, including the CryoMAZE procedure . Requires real video player Normally, electricity is conducted in a smooth, coordinated fashion from the upper to the lower chambers of the heart. As a result, the heart chambers pump in a coordinated fashion. In atrial fibrillation, the electrical activity of the heart is uncoordinated, with electricity traveling about the upper chambers in a chaotic fashion and causing the upper chambers to quiver (a "bag of worms") and contract inefficiently or not at all. Atrial fibrillation is common among patients with heart valve disease who require surgery to repair or replace the mitral valve.

86. Cardiac, Surgery For Atrial Fibrillation Columbia s surgical atrial fibrillation program is led by Michael The Columbiateam has performed surgical atrial fibrillation ablation (SAFA) in more http://www.columbiasurgery.org/pat/afib/

Atrial Fibrillation Surgery Definition Atrial fibrillation (AF) is a form of arrhythmia, or irregular heartbeat, in which the atria (the two small upper chambers of the heart) quiver instead of beating effectively. It is one of the most common forms of cardiac arrhythmia, affecting 0.4% of the general population and 5 to 10% of persons over 65 years of age. In addition, AF occurs in as many as 50% of patients undergoing cardiac operations. Abnormalities in the heart's electrical impulses in patients with AF cause blood to be pumped improperly, resulting in pooling or clotting. If a blood clot moves to an artery in the brain, AF can lead to stroke. AF is also associated with increased risk of congestive heart failure and cardiomyopathy (heart muscle disease). These risks warrant medical attention for patients with AF even if symptoms are mild. While nonsurgical treatment options, such as electrical cardioversion, often help restore a normal rhythm initially, recurrence rates as high as 75% have been reported. Columbia's surgical atrial fibrillation program is led by Michael Argenziano, MD

87. Atrial Fibrillation Describe the consequences of new onset atrial fibrillation in regards to Cardiacperformance. atrial fibrillation is so variable in its presentation, http://www.meddean.luc.edu/lumen/meded/medicine/medclerk/afib/lesson_f.htm

Atrial Fibrillation Learning Objectives (2001) Knowledge Skills Attitude Readings ... Skills in Interpreting the EKG of an Irregularly Irregular Rhythm Additional Information on Atrial Fibrillation Consequences/Risks Treatment Rate Control Planning for Cardioversion ... Antiarrhythmic Therapy PowerPoint Presentation Previous Knowledge - Students should be able to: Describe the consequences of new onset atrial fibrillation in regards to Cardiac performance. Define the risk of stroke for the patient with persistent or paroxysmal atrial fib. List five disease states associated with afib. List 6 causes of acute single or paroxysmal afib. List the three most common causes for chronic persistent atrial fibrillation. Define the relative and absolute risk reduction of Stroke for coumadin and aspirin. Figure 230-6 outlines the drug therapy for the maintenance of sinus rhythm. Classify the listed antiarrhythmics. Return to Top Skills: Recognize an irregularly irregular rhythm on examination and detect the presence of pulse deficit. Correctly diagnose afib on 12 lead EKG and differentiate it from artifact and other irregular rhythms.

88. Best Practice Medicine- Professional Reference - Atrial Fibrillation Cardiology, atrial fibrillation. Detailed recommendations in the Report,Diagnose atrial fibrillation (AF) if pulse is irregular in rate, rhythm, http://merck.micromedex.com/index.asp?page=bpm_brief&article_id=BPM01CA18

89. ATRIAL FIBRILLATION If in atrial fibrillation for longer than 48 hours, will need to be Baseline characteristics of patients with atrial fibrillation the AFFIRM Study. http://medicine.ucsf.edu/housestaff/handbook/HospH2002_C2.htm

Cardiology Victor Cheng, M.D. Joshua Lehrer-Graiwer, M.D. Gordon Fung, M.D. Chest Pain Bradycardia Tachycardia Rule out myocardial infarction ... TACHYCARDIA Follow links to corresponding sections in the Night Calls chapter. RULE OUT MYOCARDIAL INFARCTION Bed rest until ruled out (yes, this means bedpan, although bedside commode OK for soft rule out). NPO except meds if possible catheterization or functional study in AM (most patients). Oxygen via NC at 2 L/min. ECG on admission and qAM; CXR on admission (portable OK). C if diabetic. Enteric coated ASA 325 mg PO QD. Have patient chew and swallow first dose for rapid absorption. NTP q6h to chest wall according to sliding scale; after 24 hours, wipe off q night 12am-6am. (See Sliding Scales: Nitropaste Beta–blocker: use if there are no contraindications as numerous trials have shown a mortality benefit. Typical starting dose is metoprolol 25 mg PO BID or atenolol 25 mg PO QD. Alternatively, a trial of metoprolol 5 mg IV q 5 min x 3 can be given initially. If this IV dose is tolerated you can usually start 25 mg PO bid, but be sure to write hold parameters. Goal HR 50-60’s. Colace 250 mg PO bid – hold for loose stools Chest pain protocol: VS, ECG, NTG 0.4 mg SL q5 minutes x 3, call MD. When seeing patient for persistent chest pain, can give morphine in 1–2 mg boluses. If ever in doubt, call for back-up.

90. Atrial Fibrillation Videos on atrial fibrillation (link to the McGill Continuing Medical Education Web I had numerous atrial fibrillation episodes following the surgery, http://sprojects.mmi.mcgill.ca/heart/wellaf.html

Atrial Fibrillation Videos on Atrial Fibrillation: (link to the McGill Continuing Medical Education Web Site, Cardiology Section) By viewing the material on this site you understand and accept that: * The material is solely for educational purposes for qualified health care professionals. * The consortium is not liable for any decision made or action taken based on the information contained in the material on this site. * The information cannot be used as a substitute for professional care. * No physician-patient relationship is being established. I accept all of the above and would like to view the videos Atrial Fibrillation and an Atrial Myxoma Aug 1998 -J. T. @worldnet.att.net I am a 54 year old school librarian in good health. On May 1,1997, I had an atrial myxoma removed. I was told that it had been the size of a small pear and had involved the right and left atria. The convalescence was complicated by an inability to tolerate digoxin and I had to return to the hospital for an additional week to regulate medication. I have been told the the nature of the surgery impaired my heart and that atrial fibrillation will continue. (There was a possibility that the heart rate would become normal, but this is not to be). I had numerous atrial fibrillation episodes following the surgery, that last, and most worrisome, was 5/12/98 that lasted a week and caused me to miss work. Sotolol failed. In May,1998 I went into atrial fibrillation that lasted for a week. 4 verapamil a day finally slowed the heart beat and now I am on Rythmol and Aspirin.

91. Atrial Fibrillation atrial fibrillation Causes. Symptoms (Often asymptomatic in young patients) See Electrocardiogram in atrial fibrillation; Echocardiogram http://www.fpnotebook.com/CV3.htm

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92. Atrial Fibrillation DESCRIPTION atrial fibrillation (AF) is a chronic or paroxysmal arrhythmia Guidelines on the management of patients with atrial fibrillation. http://www.5mcc.com/Assets/SUMMARY/TP0098.html

Atrial fibrillation DESCRIPTION: Atrial fibrillation (AF) is a chronic or paroxysmal arrhythmia characterized by chaotic atrial electrical activity. The electrophysiologic mechanism is most likely multiple reentrant wavelets within the atria. In some patients, triggering premature atrial beats and/or bursts of tachycardia emanate from the pulmonary venous ostia or other sites. Because the AV node is bombarded with nearly continuous atrial electrical impulses, the ventricular response is irregular and usually rapid (up to or exceeding 160 beats per minute). Symptoms vary from none to mild (palpitations, lightheadedness, fatigue, poor exercise capacity) to severe (angina, dyspnea, syncope), and are frequently more serious in patients with significant structural heart disease. In some patients with Wolff- Parkinson-White syndrome, AF may be extremely rapid and degenerate into ventricular fibrillation. System(s) affected: Cardiovascular, Nervous Genetics: No specific genetic pattern in most patients Incidence/Prevalence in USA: Estimated at 1 per 1000 adults per year; estimated at 2-4% of adult population

93. Atrial Fibrillation: Symptoms And Treatment. A LearnWell Course atrial fibrillation Course AF facts and treatment, a CE course. http://www.learnwell.org/af.htm

Learn Well org Online Continuing Education in Health and Ethics, 24/7 COUNSELORS LVNs DENTAL all courses ... home Atrial Fibrillation: Symptoms and Treatment Course Number Objectives At the end of this course, you will describe 1. causes, 2. risks, 3. symptoms, 4. signs, 5. tests and 6. treatment of AFib. Credit Hours and Fee 3.0 CE Credit Hours with a fee of $24.00 Instructor Rudolf Klimes, PhD (Indiana University), MPH (Johns Hopkins University) Welcome to this 3-contact-hour Continuing Education course with instant online processing and certification 24/7. Study the course below, take the 12-question multiple-choice TEST , register and pay online. If you score 75% or above, you may print your CE certificate on your printer as soon as you finish. If you have difficulty printing your certificate, click here. You may retake the test once. Section 1-7 come in the main from the NIH, the CDC and ACC and present reliable up-to-date information. Sections 8 and 9 are more anecdotal reviews and need to be read critically and may or may not include some presently broadly accepted information. Atrial fibrillations (AF) are electrical signals in the atria that are fired in a very fast and uncontrolled manner. Electrical signals arrive in the ventricles in a completely irregular fashion, so the heart beat is irregular.

94. Atrial Fibrillation atrial fibrillation information for heart patients. http://www.guidant.com/webapp/emarketing/compass/comp.jsp?lev1=afib&lev2=glance

95. Free Online CME: Atrial Fibrillation After completing this online case, the participant should be able to define thevarious terms for atrial fibrillation, relate the common causes of atrial http://www.clevelandclinicmeded.com/decisionmaking/atrial/intro1.asp

Send this activity to a colleague ATRIAL FIBRILLATION Release Date: April 24, 2003 Renewal Date: May 25, 2005 Expiration Date: May 25, 2006 Target Audience: Primary care physicians including family practitioners and internists. OBJECTIVES After completing this case, the participant should be able to: Define the various terms for atrial fibrillation. Relate the common causes of atrial fibrillation. Describe the pathophysiology of atrial fibrillation. Discuss the drugs used in treating atrial fibrillation. Discuss the risk of thromboembolism in atrial fibrillation. ACTIVITY DESIGN Each lesson within the Disease Management Clinical Decisions series includes an interactive case, a related chapter from The Cleveland Clinic Disease Management Project, a CME test and an evaluation. Throughout the interactive case, you may proceed to the next question once you answer each question correctly. In addition to allowing you to proceed, the correct answer also reveals the rationale for the answer.

96. Atrial Fibrillation : Therapy : St. Jude Medical Therapy for atrial fibrillation. There are a number of atrial fibrillation (AF)treatment options. The first line of treatment usually involves http://www.sjm.com/conditions/condition.aspx?name=Atrial Fibrillation§ion=Th

97. Atrial Fibrillation : Symptoms, Risk Factors, Prevention, Diagnosis, Therapy, FA Learn more about the symptoms, risk factors, prevention, diagnosis, therapy,FAQs, web sites and related literature for atrial fibrillation. http://www.sjm.com/conditions/condition.aspx?name=Atrial Fibrillation

98. Management Of New Onset Atrial Fibrillation: Clinical Focus Which patients with new onset atrial fibrillation (AF) should receive attemptsat cardioversion and which should receive only conservative treatment with http://www.ahrq.gov/clinic/tp/atrialtp.htm

Atrial Fibrillation May 2000 Clinical Focus* Which patients with new onset atrial fibrillation (AF) should receive attempts at cardioversion and which should receive only conservative treatment with rate control and thromboembolism prophylaxis? What is the efficacy of electrical cardioversion alone compared with antiarrhythmic therapy alone compared with both together for patients with new onset AF? What are the risks and benefits of each of the antiarrhythmic agents used for conversion of AF and/or the maintenance of sinus rhythm after successful cardioversion? What types of therapy for AF can safely be given in an outpatient setting rather than in an inpatient setting? What is the diagnostic value of tests (e.g., transesophageal echocardiography, transthoracic echocardiography) that can be used in the evaluation of patients with new onset AF? How do various pharmacological agents differ in controlling ventricular rate in patients with AF? How does anticoagulation compare with aspirin in preventing thromboembolism in patients with AF? *Addressed in the summary or evidence report.

99. Management Of New Onset Atrial Fibrillation: Summary Of Evidence Report/Technolo atrial fibrillation (AF) is the most common arrhythmia physicians face in clinical The specific search terms included atrial fibrillation and atrial http://www.ahrq.gov/clinic/epcsums/atrialsum.htm

Evidence Report/Technology Assessment: Number 12 Management of New Onset Atrial Fibrillation Summary Under its Evidence-based Practice Program , the Agency for Healthcare Research and Quality (AHRQ) is developing scientific information for other agencies and organizations on which to base clinical guidelines, performance measures, and other quality improvement tools. Contractor institutions review all relevant scientific literature on assigned clinical care topics and produce evidence reports and technology assessments, conduct research on methodologies and the effectiveness of their implementation, and participate in technical assistance activities. Overview Purpose of Evidence Report Reporting the Evidence Methodology ... Availability of Full Report Overview Epidemiology Atrial fibrillation (AF) is the most common arrhythmia physicians face in clinical practice, accounting for about one-third of hospitalizations for arrhythmia. The prevalence of AF is 0.5 percent in those 50 to 59 years old and 8.8 percent in those 80 to 89 years old, and the incidence ranges from 0.2 percent per year in men 30 to 39 years old to 2.3 percent per year in men 80 to 89 years old. The chronic cardiac conditions most commonly associated with the development of AF are: Rheumatic mitral valve disease.

100. THE MERCK MANUAL--SECOND HOME EDITION, Atrial Fibrillation And Atrial Flutter In atrial fibrillation and atrial flutter are more common among older people. During atrial fibrillation or flutter, the contractions of the atria are so http://www.merck.com/mmhe/sec03/ch027/ch027c.html

var externalLinkWarning = "The link you have selected will take you to a site outside Merck and The Merck Manuals.*n*nThe Merck Manuals do not review or control the content of any non-Merck site. The Merck Manuals do not endorse and are not responsible for the accuracy, content, practices, or standards of any non-Merck sources."; Search The Second Home Edition , Online Version Search Index A B C D ... Z Sections Accidents and Injuries Blood Disorders Bone, Joint, and Muscle Disorders Brain, Spinal Cord, and Nerve Disorders ... Women's Health Issues Resources Anatomical Drawings Multimedia Pronunciations Weights and Measures ... , Online Version Section Heart and Blood Vessel Disorders Chapter Abnormal Heart Rhythms Topics Introduction Atrial Fibrillation and Atrial Flutter Atrial Premature Beats Bundle Branch Block Heart Block Pacemaker Dysfunction ... Wolff-Parkinson-White Syndrome Atrial Fibrillation and Atrial Flutter Buy The Book Print This Topic Email This Topic Pronunciations anticoagulants arrhythmia atrial atrial fibrillation ... ventricular tachycardia Atrial fibrillation and atrial flutter are very fast electrical discharge patterns that make the atria contract very rapidly, with some of the electrical impulses reaching the ventricles and causing them to contract faster and less efficiently than normal. Atrial fibrillation and atrial flutter are more common among older people.

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