Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- frequência de pulso irregular
Other diagnostic factors
- palpitações
- hipotensão
- pressão venosa jugular elevada
- sons cardíacos adicionais
- tontura
- dispneia
- estertores
- evidência de acidente vascular cerebral (AVC)
Risk factors
- idade mais avançada
- hipertensão
- hipotensão ortostática
- diabetes mellitus
- insuficiência cardíaca
- cardiopatias valvar e estrutural
- doença arterial coronariana e síndromes coronarianas agudas
- outras arritmias atriais
- sepse e doença crítica
- cirurgia cardíaca ou torácica
- obesidade
- hipertireoidismo
- doenças pulmonares hipóxicas
- consumo de bebidas alcoólicas
- tabagismo
- distúrbios inflamatórios
- esforço excessivo
- altura
- câncer e quimioterapia
Diagnostic investigations
1st investigations to order
- eletrocardiograma (ECG)
- eletrólitos séricos
- biomarcadores cardíacos
- testes da função tireoidiana
- radiografia torácica
- ecocardiografia transtorácica
- ecocardiografia transesofágica (ETE)
Investigations to consider
- estudo eletrofisiológico
- testes sob estresse físico
Treatment algorithm
hemodinamicamente instável
hemodinamicamente estável com trombo atrial esquerdo ou presença de trombo desconhecida/duração da FA desconhecida
hemodinamicamente estável sem trombo no átrio esquerdo: início dos sintomas <48 horas
hemodinamicamente estável sem trombo no átrio esquerdo: início dos sintomas ≥48 horas
hemodinamicamente estável sem trombo no átrio esquerdo: assintomática
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.
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
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- 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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