Atrial Fibrillation

Cardiovascular · ~11% of blueprint

Pathophysiology: Disorganized atrial electrical activity (often pulmonary vein foci) → irregular ventricular response, loss of atrial kick, stasis.
Signs & Symptoms: Palpitations, irregularly irregular pulse, fatigue, dyspnea; may be asymptomatic.
Gold Standard Diagnosis: ECG: irregularly irregular rhythm, absent P waves. Holter if paroxysmal.
First-line Treatment: Rate control (beta-blocker or non-DHP CCB) + anticoagulation per CHA₂DS₂-VASc. Cardiovert if unstable.

Drug cardsMetoprolol Diltiazem Apixaban Warfarin

High-Yield Pearl

Anticoagulate by CHA₂DS₂-VASc, not by rhythm strategy. Unstable → immediate synchronized cardioversion. Early rhythm control/ablation is now favored (Class 1) in selected younger, symptomatic patients and in HFrEF.

Sources

Reviewed September 2026

2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation — ACC/AHA/ACCP/HRS, 2023

Checked against the guideline or standard reference the exam keys to. If it has moved, use Report an error below.

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