etiology

50% of the time:

idiopathic.

Other causes are:

heart, pulm, thyroid, systemic

and “holiday heart”.

Some signs can include:

palps, syncope, thrombi, and

irreg. irreg. pulse.

EKG: fast rate

Up to 175

Irreg. irreg, too

Oops, forgot: no P’s

…Great, now I’m stuck in a verse

…Doo dee doo dee doo…

Ahem! Now, treatment:

Unstable: cardiovert

Stable: take your time.

First, calm ventricles

Rate control with Beta block-

-er, C.A. blocker.

Second, thin the blood.

This is based on CHAD-2 score.

May be chronic course.

If this doesn’t work,

And Afib won’t go away,

Third: zap the sucker.

(For all you purists,

the term is “cardiovert”

the result’s the same)

If more than 2 days

Of Afib, or unknown time,

Give warfarin FIRST,

3 weeks BEFORE zap,

goal INR 2 to 3.

Or, just TEE.

Then, give one more month

of some warfarin, or else….

They clot/die/sue you

If Afib STILL there,

you have failed as a doctor

Just kidding! Still hope!

Now think ABLATION:

Kill heart circuitry with FIRE!!

…Not work? Miller time