Chapter

Atrial Fibrillation and Flutter

Peter A. Brady

in Mayo Clinic Cardiology

Fourth edition

Published on behalf of © Mayo Foundation for Medical Education and Research

Published in print November 2012 | ISBN: 9780199915712
Published online May 2013 | e-ISBN: 9780199322824 | DOI: http://dx.doi.org/10.1093/med/9780199915712.003.0528

Series: Mayo Clinic Scientific Press

Atrial Fibrillation and Flutter

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Atrial fibrillation (AF) is the most common sustained arrhythmia, estimated to affect approximately 6 million Americans. Atrial flutter (AFL) is closely related to AF. Approximately 200,000 cases of AFL are diagnosed each year in the United States, and AFL is the most common indication for catheter ablation. Without treatment, AF is associated with an increased risk of death, thromboembolism, and stroke. In a patient with AF, rate regularization may result from transition to AFL or development of complete heart block. Less commonly, it may result from onset of a junctional or ventricular tachycardia. Primary goals in the management of AF are relief of symptoms and prevention of consequences (thromboembolism and tachycardia-induced cardiomyopathy). Restoring and maintaining normal sinus rhythm is preferred for patients with symptoms, whereas controlling the rate may be appropriate for asymptomatic patients or those who have multiple comorbid conditions. Nonpharmacologic approaches to managing AF and AFL include ablation of the AV node (with permanent pacemaker implantation), left atrial ablation aimed at isolation of the pulmonary and other thoracic veins, and surgical approaches.

Chapter.  5677 words.  Illustrated.

Subjects: Cardiovascular Medicine

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