ACLS Fast Facts on Atrial Fibrillation: 5 Things You Should Know 

Of all the different types of arrhythmias, atrial fibrillation is the most common. AFib, as it is commonly called, occurs when the upper chambers of the heart (the atria) fibrillate or twitch causing an irregular rhythm. The potentially life-threatening condition can increase a patient’s risk of stroke, heart failure and other heart-related complications. According to the Centers for Disease Control it costs more than $6.65 billion each year to treat the more than 5 million Americans that have AFib.

As the condition grows more widespread, chances are good that you may have to perform a lifesaving intervention for a patient with AFib. Understanding these key facts can help you assess AFib and respond appropriately.

1. Common symptoms of AFib include: chest pain or palpitations, shortness of breath, dizziness and possibly loss of consciousness, peripheral edema, jugular vein distention, and possibly pulmonary edema.

2. To identify AFib on an ECG monitor, look for these two characteristics:
A) the absence of p-waves before the QRS since there are no coordinated atrial contractions, and
B) irregular heart rate due to the irregular impulses that the ventricles are receiving.

3. Beta-blockers or calcium channel blockers are the preferred drug treatment for AFib when there is no evidence of heart failure (e.g., no pulmonary edema by chest x-ray; no “crackles” on lung exam). Digoxin may be given if AFib is due to heart failure or if a patient is experiencing heart failure.

4. Preventing blood clots from forming is also essential when treating AFib. Recommended blood-thinning medicines include warfarin, dabigatran, heparin, and aspirin.

5. Immediate electrical cardioversion should be performed if one of the following indications exist: ischemia, organ hypoperfusion, congestive heart failure, or a preexcitation syndrome.

6. Catheter ablation may be used to restore a normal heart rhythm when medicines or electrical cardioversion are unsuccessful. This procedure is performed by an electrophysiologist and involves inserting a wire through a vein in the leg or arm and threading it to the heart. Radio wave energy is then sent through the wire to destroy abnormal tissue that may be disrupting the normal flow of electrical signals.

For more information on atrial fibrillation and to review a sample ECG reading, check the ACLS Provider Manual. You can purchase the manual here or receive it as part of your tuition when you register for ACLS certification.