Atrial fibrillation

By: Kaytlyn Stephens, Mariette Armitstead, and Tonia Nielsen

What is a dysrhythmia?
A cardiac dysrhythmia is an abnormal heart beat: the rhythm may
be irregular in its pacing or the heart rate may be low or high.
Some dysrhythmias are potentially life threatening while other
dysrhythmias (such as sinus arrhythmia) and normal.
Supraventricular Dysrhythmias
Dysrhythmias that originate in the atria are termed
supraventricular dysrhythmias (supraventricular means above the
ventricles). These dysrhythmias include:
Atrial flutter
Atrial fibrillation
Paroxysmal Supraventricular tachycardia
Premature Atrial Contractions(PAC)
Wolff-Parkinson-White syndrome
Ventricular Dysrhythmias
Ventricular dysrhythmias begin in the ventricles
and include:
Ventricular fibrillation
Ventricular Tachycardia
Premature ventricular contractions
Long QT syndrome
Dysthymias
Tachycardia is a fast (over 100 beats per minute) heart rhythm.
Tachycardia's can originate in the atria or ventricles.

Bradycardia is a slow (under 60 beats per minute) heart rhythm.
Sinus bradycardia
Conduction Block
Sick Sinus Syndrome
Atrial fibrillation

Atrial fibrillation (also called AFib or AF) is a quivering or irregular
heartbeat (arrhythmia) that can lead to blood clots, stroke, heart
failure and other heart-related complications.
Pathophysiology
Caused by atrial fibrosis, and lost of atrial muscle mass.
The regular impulses produced by the sinus node to provide
rhythmic contraction of the heart are overwhelmed by the rapid
randomly generated electrical discharges produced by larger areas
of triggering atrial tissue.
The atria is not quadrated with the ventricles
Etiology
Abnormalities or damage to the heart's structure are the most common cause of
atrial fibrillation. Possible causes of atrial fibrillation include:

High blood pressure
Mitral regurg, Mitral stenosis
Hypoxia
Heart attacks
Coronary artery disease
Abnormal heart valves
Heart defects you're born with (congenital)
An overactive thyroid gland or other metabolic imbalance
Exposure to stimulants, such as medications, caffeine or tobacco, or to alcohol
Previous heart surgery
Viral infections
Risk Factors
Age
Heart disease
Chronic Disease
such as thyroid problems, sleep apnea, metabolic syndrome, diabetes,
chronic kidney disease or lung disease
High blood pressure
especially if it's not well-controlled with lifestyle changes or medication
Drinking alcohol
Obesity
Family history
Nursing Diagnosis
What are some nursing diagnosis
for a patient with A-Fib?
Nursing Diagnosis
Decreased Cardiac Output R/T Alterations in rate, rhythm,
electrical conduction AEB decrease BP, chest pain, Irregular
HR, pale and dyspnea.
Goal: increase cardiac output
Interventions:
Continuously monitor EKG.
Assess and document vitals and physical symptoms every 30 minutes
Supplemental O2.
Be prepared for cardioversion.
Outcome: Patient will have increased cardiac output
Nursing Diagnosis
Decreased cardiac output R/T alteration in heart rate and rhythm
AEB irregular heart rate and BP 96/50.
Goals: Pt. will maintain BP within normal limits. Pt. will have
regular cardiac rhythm.
Interventions:
Administer medications as prescribed and assess the effects of the
medications to see if helping the cardiac rhythm to be normal
Outcome: Patient maintains normal BP and has regular rhythem
Nursing Diagnosis
Anxiety RT Atrial fibrillation AEB pt statements of anxiety,
restlessness, diaphoresis, increased BP, and tachycardia
Goal: Pt will have reduced anxiety
Intervention:
Orient client to environment, equipment, medications, and routine.
Outcome: Pt was oriented to environment, equipment,
medications, and routine.
Patient Education
Explain why they are on an anticoagulant drug
They are an increased risk for stroke because of the clotting in the heart
Heart Rate control is very important.
Medications such as beta-blockers, calcium channel blockers, and digitalis can be used to
help slow conduction of electrical impulses over the AV node to maintain a heart rate less
than 80 beats per minute at rest.
Know S/S of an episode of A-Fib
Palpitations, which are sensations of a racing, uncomfortable, irregular heartbeat or a
flip-flopping in your chest
Weakness
Reduced ability to exercise
Fatigue
Lightheadedness
Dizziness
Confusion
Shortness of breath
Chest pain

Patient Education
Cardio version
cardioversion is a medical procedure done to restore a normal heart rhythm
for people who have certain heart rhythm disorders such as atrial
fibrillation.
If A-Fib as lasted longer than 48 hours
It is most often done by sending electric shocks to your heart through
electrodes placed on your chest (electrical cardioversion). Occasionally,
your doctor may perform cardioversion using only medications to restore
your heart's rhythm.