Acute Triggers of Atrial Fibrillation

Mon, 05/29/2017 - 12:00am
Author: 
Blake Siglock, MD
Editor: 
Catherine Ginty, MD

Common triggers for Atrial Fibrillation in the ED:

  • Hyperthyroidism/Thyrotoxicosis
  • Acute Myocardial Infarction
  • Alcohol binge
  • Pericarditis
  • Pulmonary Embolism
  • Dehydration
  • Recreation Drugs
  • Infection

Now, this doesn't mean that every patient coming in the ED with Afib with RVR should get a CT scn to rule out PE! However, when evaluating these patients, careful history taking and physical exam should be performed to evaluate for potential triggers guiding further lab testing, imaging and treatment.

References:

Brady, William J., Thomas S. Laughrey, and Chris A. Chaemmaghami. "Cardiac Rhythm Disturbances." Ed. Judith E. Tintinalli. Emergency Medicine: A Comprehensive Study Guide. New York: McGraw-Hill, 2011. N. pag. Print.

Lilly, Leonard S. Pathophysiology of Heart Disease. 5th ed. Baltimore: Lippincott Williams &Willkins, 2011. Print.

Ganz, Leonard I., and David Spragg. "Epidemiology of and Risk Factors for Atrial Fibrillation."Epidemiology of and Risk Factors for Atrial Fibrillation.UpToDate, 6 July 2016. Web. 25 May 2017.

 

 

Comments

It is understood that chronic conditions such as hypertension, coronary artery disease, heart failure, hypertrophic cardiomyopathy, and valvular disease, just to name a few, are risk factors for the development of atrial fibrillation.

 

However, in the ED it is important that we are aware of the acute triggers of atrial fibrillation, some of which are associated with significant morbidity and mortality.

 

Some of these triggers include:

 

  • Hyperthyroidism/Thyrotoxicosis

  • Acute Myocardial Infarction

  • Alcohol binge

  • Pericarditis

  • Pulmonary Embolism

  • Dehydration

  • Recreational Drugs

  • Infection

 

Now, this doesn’t mean that every patient coming to the ED with AFIB with RVR should get a CT scan to rule out pulmonary embolism. However, when evaluating these patients, careful history taking and physical exam should be performed to evaluate for potential triggers, guiding further laboratory testing, imaging, and treatment.

Posted by Catherine Ginty, on Sat, 05/27/2017 - 12:04pm

Comments

cginty

Sat, 05/27/2017 - 12:04pm

Comment: 

It is understood that chronic conditions such as hypertension, coronary artery disease, heart failure, hypertrophic cardiomyopathy, and valvular disease, just to name a few, are risk factors for the development of atrial fibrillation.

 

However, in the ED it is important that we are aware of the acute triggers of atrial fibrillation, some of which are associated with significant morbidity and mortality.

 

Some of these triggers include:

 

  • Hyperthyroidism/Thyrotoxicosis

  • Acute Myocardial Infarction

  • Alcohol binge

  • Pericarditis

  • Pulmonary Embolism

  • Dehydration

  • Recreational Drugs

  • Infection

 

Now, this doesn’t mean that every patient coming to the ED with AFIB with RVR should get a CT scan to rule out pulmonary embolism. However, when evaluating these patients, careful history taking and physical exam should be performed to evaluate for potential triggers, guiding further laboratory testing, imaging, and treatment.

Kate Ginty M.D.