ABC of Atrial Fibrillation: AETIOLOGY, PATHOPHYSIOLOGY, AND CLINICAL FEATURES

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Abstract
Aetiology Ischaemic heart disease Ischaemic heart disease is probably the most common underlying cause of atrial fibrillation in Britain. In addition, the fast ventricular rate due to atrial fibrillation may cause angina, leading to cardiac ischaemia and heart failure. Atrial fibrillation may complicate acute myocardial infarction in 10-15% of cases and is often a marker of extensive myocardial damage and a poor prognosis, with increased mortality. If atrial fibrillation occurs with an acute myocardial infarction, it tends to occur in the first 24 hours and is usually self limiting. Patients should be observed unless fast atrial fibrillation occurs or the patient is haemodynamically compromised. Atrial fibrillation is also a marker of underlying ventricular dysfunction and a compromised myocardium. Many years after myocardial infarction, ventricular scarring and dilatation often predispose to atrial fibrillation and congestive heart failure. View this table: In this window In a new window

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