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Slow Atrial Fibrillation

February 15th, 2021


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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