Summary
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
- pulso irregular
Other diagnostic factors
- palpitaciones
- hipotensión
- aumento de la presión venosa yugular
- ruidos cardíacos adicionales
- mareos
- disnea
- estertores
- evidencia de accidente cerebrovascular
Risk factors
- mayor edad
- hipertensión
- hipotensión ortostática
- diabetes mellitus
- insuficiencia cardíaca.
- cardiopatía valvular y cardiopatía estructural
- arteriopatía coronaria y síndrome coronario agudo
- otras arritmias auriculares
- sepsis y enfermedades críticas
- cirugía cardíaca o torácica
- obesidad
- hipertiroidismo
- enfermedades pulmonares hipóxicas
- consumo de alcohol
- tabaquismo
- trastornos inflamatorios
- ejercicio excesivo
- estatura
- cáncer y quimioterapia
Diagnostic investigations
1st investigations to order
- electrocardiograma (ECG)
- electrolitos séricos
- biomarcadores cardíacos
- pruebas de función tiroidea
- radiografía del tórax (RT)
- ecocardiograma transtorácico
- ecocardiograma transesofágico (ETE)
Investigations to consider
- estudio electrofisiológico
- pruebas de esfuerzo con ejercicio
Treatment algorithm
hemodinámicamente inestable
hemodinámicamente estable con trombo en la aurícula izquierda, o presencia de trombo desconocida/duración de la FA desconocida
hemodinámicamente estables sin trombo en la aurícula izquierda: inicio de síntomas <48 horas
hemodinámicamente estables sin trombo en la aurícula izquierda: inicio de síntomas ≥48 horas
hemodinámicamente estables sin trombo en la aurícula izquierda: asintomático
Contributors
Authors
Arti N. Shah, MS, MD
Director
Cardiac Electrophysiology
Elmhurst Hospital Center
Elmhurst
Assistant Professor of Medicine
Mount Sinai School of Medicine
New York
NY
Disclosures
ANS declares that she has no competing interests.
Bharat K. Kantharia, MD, FRCP, FAHA, FACC, FESC, FHRS
Clinical Professor of Medicine
Icahn School of Medicine at Mount Sinai
President
Cardiovascular and Heart Rhythm Consultants
Attending and Consultant Cardiac Electrophysiologist
Mount Sinai Hospitals
New York Methodist Hospital
New York
NY
Disclosures
BKK declares that he has no competing interests.
Peer reviewers
Diwakar Jain, MD, FACC, FRCP, FASNC
Professor of Medicine (Cardiology)
Westchester Medical Center
Valhalla
NY
Disclosures
DJ declares that he has no competing interests.
Farooq A. Padder, MD, MRCP, FACC
Assistant Professor of Medicine
Hahnemann University Hospital
Woodbury
NJ
Disclosures
FAP declares that he has no competing interests.
Kim Rajappan, MA, MD, MRCP
Consultant Cardiologist and Electrophysiologist
Cardiac Department
John Radcliffe Hospital
Oxford
UK
Disclosures
KR declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2024 Jan 2;149(1):e1-156.Full text Abstract
Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498.Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Differentials
- Aleteo auricular
- Síndrome de Wolff-Parkinson-White
- Taquicardia auricular
More DifferentialsGuidelines
- 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines
- 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines
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Atrial fibrillation: what are the treatment options?
Atrial fibrillation: what is it?
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