Slow Atrial Fibrillation
Overview
Atrial fibrillation is most commonly associated with a rapid ventricular response, though AF with a slow ventricular response may occur when there is reduced conduction of fibrillatory waves through the conduction pathways.
Look For
- Bradycardia with ventricular rate <60
- Irregular rhythm
- No P waves, with oscillating baseline waves
Causes of Atrial Fibrillation
- Severe acute illness - especially in septic or postoperative patients
- Cardiac - post cardiac surgery, myocardial infarction, valvular disease, cardiomyopathy, congestive cardiac failure, congenital heart disease, Wolff-Parkinson-White
- Cardiovascular risk factors - hypertension, diabetes, obesity
- Pulmonary embolism
- Obstructive sleep apnoea
- Thyrotoxicosis
- Alcohol abuse
Causes of Slowed Ventricular Response
- Complete heart block
- Drugs - beta blockers, calcium channel blockers, digoxin
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