ECG Changes: Atrial Fibrillation

• The atrial wall is quivering (not pumping any blood with it)
• The EKG will not have a P-wave, and instead there will be a quivery/shaky line
• On the axis: P (ind) – indeterminant
• The AV node will absorb one signal and send it down to the vent, but it can’t pick up one in a rhythmic pattern, therefore these pts will have arrhythmia. There are too many signals for the AV node to have a constant rhythm.
• The mechanism is sympathetico-tonia
• These pts may die b/c clots form in the atria due to pooled blood, most commonly in the retro-pharyngeal pocket in the atrium. When these clots leave the atrium, enter & leave the vent, and end up in the lungs or aorta
• These are found by a retro esophageal ultrasound.
• These is no effective medical treatment, pts are on beta-blockers & Ca channel blocking, warfarin -or- cumarin for clots, Cardio-version is another option for certain pts (pt is sedated & then the heart is shocked to get it back to sinus rhythm). Sex has also been shown to help as a treatment
• These pts generally feel sick, weak, tired, nausea
• These pts need to totally get off of all stimulants (caffeine…)
• These pts have been shown to have upper thoracic involvement; therefore chiropractic, osteopathic, & acupuncture could & should be promoted here
• The sympathetics are not as dense in the atrial wall as in vents
• Parasympathetics dominate in the atria
• If atrial wall is contraction is contracting <200x/min>
• If atrial wall is contraction is contracting >250x/min = fibrillation
• The heart maintains function, but the main fear is blood clot

Category: Cardiology Notes