Atrial Fibrillation: Etiology, Diagnosis, and Inital Workup

Rajneesh Calton, MD, FACC, Division of Cardiac Electrophysiology, University Health Network, Toronto General Hospital, Toronto, ON.
Vijay Chauhan, MD, FRCPC, Division of Cardiac Electrophysiology, University Health Network, Toronto General Hospital, Toronto, ON.
Kumaraswamy Nanthakumar, MD, FRCPC, Division of Cardiac Electrophysiology, University Health Network, Toronto General Hospital, Toronto, ON.

Atrial fibrillation (AF) is the most common sustained cardiac rhythm disturbance for which patients seek medical attention. AF has a heterogeneous clinical presentation, occurring in the presence or absence of detectable heart disease or related symptoms. Depending upon the duration and response to pharmacological and electrical cardioversion, AF can be classified as paroxysmal, persistent, or permanent. AF can be isolated or associated with other arrhythmias, often atrial flutter or atrial tachycardia. Minimum clinical evaluation of a patient with AF includes history, physical examination, and ECG documentation by at least single-lead ECG recording during the dysrhythmia. Additional investigation may include Holter monitoring, exercise testing, transesophageal echocardiography, and/or electrophysiological study.
Key words: arrhythmia, atrial fibrillation, Holter monitoring, atrial tachycardia.