Atrial Fibrillation

Professor Ralph Stewart, a cardiologist at Auckland City Hospital and the Auckland Heart Group and Honorary Professor of Medicine at the University of Auckland discussed the management of 3 common presentations with atrial fibrillation:

1. A patient who presents acutely with rapid irregular palpitations.
2. A patient who gives a history of palpitations who is currently well in sinus rhythm.
3. A patient who is asymptomatic but is found to have an irregular pulse.

For each of these situations, discussion focusssed on:

• Diagnosis and investigation
• Acute management
• Indications for referral
• Management of heart rhythm (cardioversion and antiarrhythmic drugs), and heart rate.
• When are oral anticoagulants indicated to reduce the risk of stroke
• When are anticoagulants not indicated
• The importance of individualising care

Resources

• Management of artial fibrillation in general practice bpac^nz (2011)
• Cardiovascular Disease Risk Assessment NZ Primary Care Handbook
• Cardiovascular Disease Risk Assessment and Management for Primary Care