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Tachycardia: Difference between revisions
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====Clinical diagnosis:==== | ====Clinical diagnosis:==== | ||
AF is the most common supraventricular arrhythmia in Western society. Patients can experience complaints from palpitations, dyspnuea and dizziness. It is characterized by the absence of clear P-waves on the surface ECG and an irregular ventricular ventricular rate. On physical examination an irregular pulse can be felt, however this is not diagnostic of AF as other causes can cause an irregular pulse (atrial or ventricular extra systoles).The cardiac output is reduced due to lack of atrial kick. Furthermore due to the higher ventricular rate the heart has not enough time to completely fill with blood. The development of AF is associated with different diseases for instance hypertension, mitral valve disease, thyroid disease and diabetes.<cite>Nieuwlaat</cite> AF usually starts with short single isolated episodes of AF which are self terminating. Progressively over time these episodes are of longer duration and occur more frequently. These episodes progress to persistent AF, which last longer than 7 days or can only be terminated by cardioversion. In the end AF is permanent en AF is not possible or duration of sinus rhythm is short. Episodes of AF can be symptomatic, but patients can experience no symptoms during AF. AF is classified according to the clinical presentation of AF:<cite>Camm2010</cite> | AF is the most common supraventricular arrhythmia in Western society. Patients can experience complaints from palpitations, dyspnuea and dizziness. It is characterized by the absence of clear P-waves on the surface ECG and an irregular ventricular ventricular rate. On physical examination an irregular pulse can be felt, however this is not diagnostic of AF as other causes can cause an irregular pulse (atrial or ventricular extra systoles).The cardiac output is reduced due to lack of atrial kick. Furthermore due to the higher ventricular rate the heart has not enough time to completely fill with blood. The development of AF is associated with different diseases for instance hypertension, mitral valve disease, thyroid disease and diabetes.<cite>Nieuwlaat</cite> AF usually starts with short single isolated episodes of AF which are self terminating. Progressively over time these episodes are of longer duration and occur more frequently. These episodes progress to persistent AF, which last longer than 7 days or can only be terminated by cardioversion. In the end AF is permanent en AF is not possible or duration of sinus rhythm is short. Episodes of AF can be symptomatic, but patients can experience no symptoms during AF. However it is important to note that the risk of complications of AF are unrelated to the duration of the episodes. <cite>Friberg</cite> AF is classified according to the clinical presentation of AF:<cite>Camm2010</cite> | ||
* Paroxysmal atrial fibrillation: Episodes AF lasting shorter than 7 days and terminating spontaneously usually within 48 hours. | * Paroxysmal atrial fibrillation: Episodes AF lasting shorter than 7 days and terminating spontaneously usually within 48 hours. | ||
* Persistent atrial fibrillation: Episodes of AF not terminating spontaneously or lasting longer than 7 days or requires cardioversion | * Persistent atrial fibrillation: Episodes of AF not terminating spontaneously or lasting longer than 7 days or requires cardioversion | ||