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Novo episódio de fibrilação atrial

Last reviewed: 9 Jun 2025
Last updated: 06 Aug 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • frequência de pulso irregular
Full details

Other diagnostic factors

  • palpitações
  • hipotensão
  • pressão venosa jugular elevada
  • sons cardíacos adicionais
  • tontura
  • dispneia
  • estertores
  • evidência de acidente vascular cerebral (AVC)
Full details

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
Full details

Diagnostic investigations

1st investigations to order

  • eletrocardiograma (ECG)
  • eletrólitos séricos
  • biomarcadores cardíacos
  • testes da função tireoidiana
  • radiografia torácica
  • ecocardiografia transtorácica
  • ecocardiografia transesofágica (ETE)
Full details

Investigations to consider

  • estudo eletrofisiológico
  • testes sob estresse físico
Full details

Treatment algorithm

INITIAL

hemodinamicamente instável

ACUTE

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
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  • 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
    • 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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