Atrial fibrillation (acute onset)


Acute atrial fibrillation is rapid, irregular, and chaotic atrial activity of less than 48 hours' duration. It includes both the first symptomatic onset of chronic or persistent atrial fibrillation and episodes of paroxysmal atrial fibrillation. It is sometimes difficult to distinguish new-onset atrial fibrillation from previously undiagnosed long-standing atrial fibrillation. Atrial fibrillation within 72 hours of onset is sometimes called recent-onset atrial fibrillation. Definitions of acute atrial fibrillation vary, but for the purposes of this review we have included studies where atrial fibrillation may have occurred up to 7 days previously. By contrast, chronic atrial fibrillation is more sustained and can be described as paroxysmal (with spontaneous termination and sinus rhythm between recurrences), persistent, or permanent atrial fibrillation. This review deals with people with acute and recent atrial fibrillation who are haemodynamically stable. The consensus is that people who are not haemodynamically stable should be treated with immediate direct current cardioversion. We have excluded studies in people with atrial fibrillation arising during or soon after cardiac surgery. Diagnosis: Acute atrial fibrillation should be suspected in people presenting with dizziness, syncope, dyspnoea, or palpitations. Moreover, atrial fibrillation can contribute to a large number of other non-specific symptoms. Palpation of an irregular pulse is generally only considered sufficient to raise suspicion of atrial fibrillation; diagnosis requires confirmation with ECG. However, in those with paroxysmal atrial fibrillation, ambulatory monitoring may be required.[1]

Latest citations

Cryptogenic stroke and underlying atrial fibrillation. (18 July 2014)

High-Sensitivity Troponin I for Risk Assessment in Patients With Atrial Fibrillation: Insights From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial. (31 March 2014)