Atrial Fibrillation (A-Fib) is like your jealous ex who keeps trying to plague the heart with recurrence. I like to think of A-Fib as “Dementia of the heart” and A-Fib with RVR as “Delirium of the heart”. If you look up risk factors of Dementia and A-Fib, they are very similar and frequently co-exist – indeed some scientists think Paroxysmal AFib throwing up micro-clots to the brain is probably contributory to vascular dementia!
Identifying & mitigating triggers & risk factors of A-Fib may not only help flip your patient back to a normal sinus rhythm – but may prevent recurrences and even control heart rate better in Chronic A-Fibbers.
A very cool mnemonic to recall A-Fib causes, triggers & risk-factors, is “THIS MAD PACE” or-“THIS DAM PACE” 😉
T – Thyroid excess
H – Hypertension (***number one risk factor***)
I – Infections
S – Surgery recent (esp Cardiovascular), Smoking
M – Medications ( ‘DIAF’ )
A – APCs (Atrial Premature Complexes or PACs)
D – Dehydration, Diabetes
P – Pulm Embolism, Pneumothorax & other Pulm disease
A – Alcohol binge drinking
C – Cardiac causes, (e.g post-CABG, ACS/MI, valve disease), Central Lines
E – Electrolyte Abnormalities including low Magnesium
And no – contrary to popular belief, Caffeine consumption does NOT increase the risk of Atrial Fibrillation…
P.S. : Fixing AFib-RVR with ACBDEF
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