Classification of AF

To aid treatment decisions, AF is classified into five types:

First diagnosed AF is classified for every patient seen with AF for the first time irrespective of the duration of the arrhythmia, or the presence and severity of AF-related symptoms.

Paroxysmal AF usually lasts no more than 48 hours, ending without any clinical intervention. Where an episode lasts for more than 48 hours, anticoagulation treatment will be considered.

Persistent AF is present when an episode lasts longer than seven days or requires restoration of normal (sinus) rhythm using cardioversion – achieved medically or electrically.

Long-standing persistent AF has lasted for one year or more, following a decision to adopt a rhythm control strategy with the patient.

Permanent AF exists when the patient and the physician have accepted the constant presence of the arrhythmia.  In these cases; no further attempt to control the rhythm is made.
 


 

Diagnosing AF

Atrial Fibrillation (AF) may often be the result of an underlying disorder. A careful clinical history must be taken and routine haematology, biochemistry and thyroid function tests are taken for patients newly presenting with AF.

AF may be suspected clinically by the presence of an irregular pulse but diagnosis can only be confirmed by documentation of the rhythm on an electrocardiogram (ECG)

Diagnostic 12 lead ECG features include the absence of a P wave, the presence of an irregular QRS response and fine fluctuations on the baseline throughout, representing asynchronous atrial electrical activity. The P wave may be visible in some patients with AF but  it will change shape and size over the period of the ECG recording. By contrast in sinus rhythm or atrial flutter the P wave looks exactly the same shape and size throughout.

The European guidelines for the management of AF (2010) recommend the following characteristics to diagnose AF (figure 2).

In patients where AF is suspected but not picked up on an ECG, intensive rhythm monitoring may be required to diagnose the arrhythmia.

Patients with paroxysmal AF may require ambulatory monitoring or if the paroxysms are infrequent a patient activated recorder to catch an episode of the arrhythmia and confirm the diagnosis may be required.

Useful Link: Read more on detection, ECG interpretation and diagnosis of AF

 

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Classification and Diagnostics

Classification of AF

To aid treatment decisions, AF is classified into five types:

First diagnosed AF is classified for every patient seen with AF for the first time irrespective of the duration of the arrhythmia, or the presence and severity of AF-related symptoms.

Paroxysmal AF usually lasts no more than 48 hours, ending without any clinical intervention. Where an episode lasts for more than 48 hours, anticoagulation treatment will be considered.

Persistent AF is present when an episode lasts longer than seven days or requires restoration of normal (sinus) rhythm using cardioversion – achieved medically or electrically.

Long-standing persistent AF has lasted for one year or more, following a decision to adopt a rhythm control strategy with the patient.

Permanent AF exists when the patient and the physician have accepted the constant presence of the arrhythmia.  In these cases; no further attempt to control the rhythm is made.
 


 

Diagnosing AF

Atrial Fibrillation (AF) may often be the result of an underlying disorder. A careful clinical history must be taken and routine haematology, biochemistry and thyroid function tests are taken for patients newly presenting with AF.

AF may be suspected clinically by the presence of an irregular pulse but diagnosis can only be confirmed by documentation of the rhythm on an electrocardiogram (ECG)

Diagnostic 12 lead ECG features include the absence of a P wave, the presence of an irregular QRS response and fine fluctuations on the baseline throughout, representing asynchronous atrial electrical activity. The P wave may be visible in some patients with AF but  it will change shape and size over the period of the ECG recording. By contrast in sinus rhythm or atrial flutter the P wave looks exactly the same shape and size throughout.

The European guidelines for the management of AF (2010) recommend the following characteristics to diagnose AF (figure 2).

In patients where AF is suspected but not picked up on an ECG, intensive rhythm monitoring may be required to diagnose the arrhythmia.

Patients with paroxysmal AF may require ambulatory monitoring or if the paroxysms are infrequent a patient activated recorder to catch an episode of the arrhythmia and confirm the diagnosis may be required.

Useful Link: Read more on detection, ECG interpretation and diagnosis of AF

 

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