Etiology + Pathogenesis

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Atria (Especially LA) becomes dilated → stretching of myocytes → electrical activity goes wack.

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• Structural heart disease → Atrial dilation
  • Vavular diseases
    • Mitral Valve Stenosis or MR - Mitral Valve Regurgitation
  • HF - Heart Failure
    • HFpEF (HF w/ preserved EF)
  • Cardiomyopathy
  • Prior !MI (Injury or remodelling of electrical conduction can also cause Afib)
• ↑High BP → Atrial dilation
  • Back pressure from LV (atria does not have enough muscle to hypertrophy) → This back pressure then causes PH - Pulmonary hypertension → Atria dilation

Triggers & Risk Factors

• Age (Older Adult > 65 (RF))
• Obstructive OSA - Obstructive Sleep Apnea → Elevated BP
• Alcohol (RF)
  • Directly toxic to myocytes → injured/dead myocytes
  • If you stop drinking, you can get better
• Thyrotoxicosis ↑(hyperthyroidism) → Elevated sBP (in Older Adult > 65 (RF))
• Myopericarditis
• Lung diseases
  • Acute!PE - Pulmonary embolism
  • Pneumonia
• After Cardiac Surgery Procedures
• Certain drugs or supplements

Prognosis + Complications

• Loss of atrial kick → decreased CO
  • HF - Heart Failure
  • Sudden !Cardiac Arrest
• Stats of blood → thromboembolism
  • !Stroke (CVA) (most frequent major complication)
  • !MI
  • Silent cerebral ischemia
  • Cognitive impairment and dementia

Acute Management

AED (defibrillator) → Emerg. only (when it may turn into VF)