ECG Quest > Rhythms > Atrial Rhythms > Atrial fibrillation

Atrial fibrillation

Atrial fibrillation is a common arrhythmia with absent P waves and irregular (irregularly irregular) QRS complexes. The baseline may have coarse or fine fibrillation waves.

Atrial fibrillation should always be described with the rate of ventricular response, e.g. AF with a rapid ventricular response. Slow AF can be a sign of a sick AV node, if the patient is on no rate-slowing medications.

Atrial fibrilation can be paroxysmal, persistent or permanent. It can also be described as valvular or non-valvular. Treatment options include rate control and rhythm control.

Atrial fibrillation is frequently over-diagnosed by machine interpretation, as it tends to mistake baseline / movement artefact for fibrillation waves. Patients with atrial flutter frequently have periods of atrial fibrillation.

See also: Atrial Rhythms

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References

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In the ECGquest archives, this ECG has been tagged with: - Loss of consciousness Seizure Irregular Narrow QRS Wide QRS Atrial fibrillation Change in rhythm 12-Lead Dr Smith's ECG Blog CC BY-NC
What is this tachycardia that alternates from wide to narrow to wide?

This ECG is from a patient in their 50s who presented unconscious and tachycardic after a seizure.

This ECG shows alternating wide and narrow complex tachycardias at the same rate, likely due to aberrancy.

In the ECGquest archives, this ECG has been tagged with: - Nonspecific baseline artefact Atrial fibrillation Ventricular pacemaker 12-Lead Dr Smith's ECG Blog K. Wang CC BY-NC
Computer often fails to diagnose atrial fibrillation in ventricular paced rhythm, and that can be catastrophic

This ECG is from an elderly patient who presented with a massive hemiplegic ischemic stroke due to MCA thrombus.

This ECG shows atrial fibrillation with ventricular pacemaker and significant artefact. The AF went undiagnosed.

In the ECGquest archives, this ECG has been tagged with: - Irregular Normal rate Tall U waves Wide QRS Atrial fibrillation Hypokalemia 12-Lead Dr Smith's ECG Blog CC BY-NC
Pre-existing Left Bundle Branch Block and Atrial Fib: what is alarming on this routine pre-procedure ECG?

This ECG is from an elderly patient who had a routine pre-procedure ECG.

This ECG shows atrial fibrillation with LBBB (old) and large U waves. The cause was hypokalemia.

In the ECGquest archives, this ECG has been tagged with: - Bradycardia Irregular Normal Axis Absent P waves RSR' Wide QRS Atrial fibrillation 12-Lead ECG of the Week CC-BY-NC-SA
ECG of the Week – 1st October 2018 – Interpretation

This ECG is from a man in his 80s who presented feeling generally unwell and nauseous, on a background of chronic atrial fibrillation, diabetes and hypertension.

In the ECGquest archives, this ECG has been tagged with: - Dizziness Bradycardia Normal Axis Regular Absent P waves Atrial fibrillation Junctional escape Third degree AV block 12-Lead ECG of the Week CC-BY-NC-SA
ECG of the Week – 17th September 2018 – Interpretation

This ECG is from a woman in her 70s who complained of dizziness on a background of ischaemic heart disease, atrial fibrillation and diabetes.

In the ECGquest archives, this ECG has been tagged with: - Syncope Normal rate Atrial fibrillation Sick sinus syndrome 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
Syncope and Atrial fibrillation in a Healthy 70-something Male

This ECG is from a man in his 70s presented with syncope for 20 seconds. He had no past medical history. He recovered fully.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Palpitations Irregular Anterior ST elevation J wave Widespread ST elevation Atrial fibrillation Normal ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Palpitations and Chest Tightness: Should You Activate the Cath Lab (or Give Thrombolytics)?

This ECG is from a man in his 20s with palpitations and chest tightness on a background of Wolff Parkinson White syndrome.

In the ECGquest archives, this ECG has been tagged with: - Cardiac arrest Anterior ST depression ST elevation in aVR Atrial fibrillation Multi-vessel disease 12-Lead Dr Smith's ECG Blog CC BY-NC
Cardiac arrest #3: ST depression, Is it STEMI? or is he an ACCESS Trial Candidate?
In the ECGquest archives, this ECG has been tagged with: - Dizziness Irregular Left Axis Deviation Normal rate Narrow QRS Atrial fibrillation 12-Lead ECG of the Week Dr John Larkin CC-BY-NC-SA
ECG of the Week – 19th March 2018 – Interpretation

This ECG is from a man in his 80s who presented with dizziness and an abnormal gait.

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