Overview
Definition
A supraventricular tachyarrhythmia characterized by uncoordinated atrial activation with consequent deterioration of atrial mechanical function.
Epidemiology
The most common sustained cardiac arrhythmia. Affects ~33 million globally. Risk increases with age.
Etiology & Risk Factors
- Hypertension
- Coronary artery disease
- Valvular heart disease
- Thyrotoxicosis
- Alcohol consumption ('Holiday Heart')
Clinical Symptoms
- Palpitations
- Shortness of breath
- Fatigue
- Dizziness
- Can be completely asymptomatic
Clinical Approach
Diagnosis
- ECG (Irregularly irregular rhythm, absence of distinct P waves)
- Holter monitor (if paroxysmal)
- Echocardiogram (assess for structural heart disease)
Management
- Rate control (Beta-blockers, Non-dihydropyridine CCBs, Digoxin)
- Rhythm control (Amiodarone, Flecainide, Cardioversion, Ablation)
- Anticoagulation for stroke prevention based on CHA2DS2-VASc score (DOACs or Warfarin)
Complications
- Ischemic Stroke
- Heart Failure
- Tachycardia-induced cardiomyopathy