Chaotic and irregular atrial arrhythmia, the prevalence of which increases progressively with age.
Patients are generally septuagenarian or older. They frequently have coexisting cardiac or noncardiac problems, such as hypertension, coronary artery disease, valvular disease, heart failure, obesity, and sleep apnea or pulmonary disease.
Causes significant morbidity and mortality including palpitations, dyspnea, angina, dizziness or syncope, and features of CHF, tachycardia-induced cardiomyopathy, stroke, and death. Many patients are asymptomatic or have symptoms that are less specific for cardiac arrhythmias, such as mild dementia or silent strokes.
ECG shows absent P waves, presence of fibrillatory waves, and irregularly irregular QRS complexes.
Treatment strategy depends on the severity of symptoms, the duration of AF, and the presence of comorbid conditions. Treatment involves correction of the abnormal rate, or rate plus rhythm, along with anticoagulation in high-risk patients.
Risks and benefits of a chosen therapy, such as rate control or rhythm control strategies utilizing beta-blockers, calcium blockers, digoxin, antiarrhythmic agents, ablation for pulmonary vein isolation and left atrial substrate modification, pacemakers, and ablation of the atrioventricular node need to be weighed based on multiple clinical factors to optimize patient outcome.