10% of the US population of 80 years of age and above suffer from atrial fibrillation. Sometimes, the patient does not notice atrial fibrillation for a long time, which results in sufficient cardiac remodeling. This makes establishing a sinus rhythm very difficult. In this video, Dr. Syed discusses the definition, presentation, pathology, EKG, and salient points of management of the atrial fibrillation. The following aspects are discussed in detail: 1. Loss of atrial function during the episodes of the atrial fibrillation. 2. The risk of thrombus formation and duration of fibrillation where this risk increases significantly so that cardioversion is contra-indicated. 3. Atrial fibrillation caused by failing heart and ischemic injury. 4. Cardiac remodeling at a macro and cellular level during the long-standing atrial fibrillation and why cardioversion becomes difficult. 5. Development of the reentry circuits and the need for catheter ablation. 6. EKG interpretation of the atrial fibrillation. 7. JVP changes (absence of the A wave) during the atrial fibrillation. 8. The absence of the S4 heart sound due to the atrial fibrillation where this abnormal sound is expected. 9. Pharmacological management and cardioversion approaches. 10. Catheter ablation indication and possible methods. 11. Clinical types/stages of atrial fibrillation.
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