atrial fibrillation
Noun | 1. | atrial fibrillation - fibrillation of the muscles of the atria of the heart |
单词 | atrial fibrillation | |||
释义 | atrial fibrillation
atrial fibrillationfibrillation[fi″brĭ-la´shun]a·tri·al fi·bril·la·tion, auricular fibrillationatrial fibrillationatrial fibrillationCardiology The most frequent sustained cardiac arrhythmia, which is very common in older individuals and characterized by disorganized electrical conduction in the atria, resulting in ineffective pumping of blood into the ventricle; ± 1 x 106 in US have AF; 80% also have heart disease Etiology HTN, heart failure, valve disease–mitral valve prolapse, rheumatic heart disease, especially when associated with clinically silent mitral stenosis, dilated cardiomyopathy, pericarditis, cardiothoracic surgery, hyperthyroidism, alcohol use or withdrawal, acute illness–eg, pneumonia, decompensated COPD, sepsis, and other conditions, PTE, sympathetic triggers–eg, cocaine, amphetamines, atrial myxoma, tachycardia-bradycardia syndrome, lone AF Risk factors DM, MI, HTN, ↑ age–peak at age 75-79; untreated AF Pts suffer strokes at a rate of 4.5%/yr Sequelae Loss of coordinated electromechanical activity, resulting in blood stasis and atrial thrombosis; AF precipitates heart failure as it results in the loss of the so-called atrial kick, which accounts for 5-30% of cardiac output, and a shorter diastole Clinical Palpitations, dizziness, dyspnea, angina, syncope EKG Narrow QRS complex < 120 msec with no interval between the QRS complexes; absent P waves in leads II, III, aVF, and V1-2 Workup Hx, especially alcohol or drug abuse, thyroid studies, CBC, chemical profile, CXR for pulmonary disease and/or heart failure, EKG, echocardiogram Diagnosis Transesophageal echocardiography identifies Pts with atrial emboli requiring short-term anticoagulation with heparin before cardioversion. See Linkage analysis Management-acute Adenosine, digoxin, magnesium sulfate, CCBs–eg, verapamil, diltiazem Management-long term Cardioversion, anticoagulation Medical conversion of AF Class IA antiarrhythmics–eg, quinidine as well as disopyramide, procainamide, performed as an inpatient; class IC agents–eg, flecanide, propafenone, or class III agents–eg, amiodarone, sotalol are increasingly popular in acute conversion of AF to a sinus rhythm, as is Ibutilide Interventional conversion of AF Failure of medical conversion of AF to a sinus rhythm, accompanied by ventricular rates unresponsive to antiarrhythmics, requires AV node-His bundle ablation with implantation of a rate-adaptive VVI pacemaker, or preferably, atrial or dual chamber pacing, as the incidence of AF is lower than with VVI pacing. See Atrial kick, Atrial flutter.a·tri·al fi·bril·la·tion, auricular fibrillation (ā'trē-ăl fib'ri-lā'shŭn, aw-rik'yū-lăr)atrial fibrillationA heart defect involving the upper chambers in which the rate at which they contract is chaotically irregular both in force and speed. It may be caused by heart muscle damage from RHEUMATIC FEVER or ATHEROSCLEROSIS or by thyroid overactivity. A new focus in the muscle may set up its own rhythm and this may compete with the normal rhythm. Only some of the irregular beats are transmitted down to the lower chambers (ventricles) and the pulse is correspondingly irregular. Atrial fibrillation is common and accounts for one third of all strokes in people over 65 years of age. A rare familial form has been recognized. Treatment by radio frequency ablation using a catheter in a pulmonary vein is usually effective in controlling the disorder. Fibrillation of recent onset can usually be stopped by a single oral dose of flecainide or propafenone.Atrial fibrillationa·tri·al fi·bril·la·tion, auricular fibrillation (ā'trē-ăl fib'ri-lā'shŭn, aw-rik'yū-lăr)See AFib atrial fibrillation
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