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Atrial fibrillation: natural history, complications, and management

J S Alpert1, P Petersen, J Godtfredsen

  • 1Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester 01605.

Annual Review of Medicine
|January 1, 1988
PubMed

Insights

Atrial fibrillation, a common heart rhythm disorder, increases stroke and death risks. It can be treated with electrical or drug therapies, including amiodarone, to restore normal sinus rhythm.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Atrial fibrillation is a significant arrhythmia with major prognostic and therapeutic implications.
  • Common causes include hypertension, ischemic heart disease, and rheumatic valvular disease.
  • Atrial fibrillation increases the risk of embolic stroke and mortality.

Purpose of the Study:

  • To summarize the clinical significance, causes, and management of atrial fibrillation.
  • To highlight the impact of atrial fibrillation on cardiac output and stroke risk.
  • To discuss reversion strategies for atrial fibrillation.

Main Methods:

  • Review of existing literature on atrial fibrillation.
  • Analysis of the physiological consequences of atrial fibrillation, including loss of atrial kick.
  • Evaluation of therapeutic interventions for atrial fibrillation.

Main Results:

  • Loss of atrial kick in atrial fibrillation leads to a 20-30% decline in stroke output, more pronounced in patients with heart disease.
  • Atrial fibrillation is associated with increased risks of embolic stroke and death.
  • Electrical and pharmacological cardioversion are effective in restoring sinus rhythm.

Conclusions:

  • Atrial fibrillation is a serious condition requiring prompt management.
  • Therapeutic interventions, including amiodarone, can successfully revert atrial fibrillation to sinus rhythm, even in refractory cases.

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