Laboratory Medicine

Atrial fibrillation in clinical practice by Gregory Y. H. Lip

By Gregory Y. H. Lip

Atrial traumatic inflammation is the most typical sustained cardiac rhythm ailment which confers major mortality and morbidity from stroke, thromboembolism and center failure. Atrial traumatic inflammation is encountered in a wide selection of medical settings, together with ischaemic middle affliction, valve disorder, high blood pressure, thyroid ailment and submit operatively. there were new and dramatic advancements in atrial traumatic inflammation, in regards to non-pharmacological administration recommendations and antithrombotic remedy. This booklet units out a logical method of the sensible and medical administration of this universal cardiac arrhythmia. Illustrated with 86 ECGs and line drawings, and broadly referenced, it's a precise advisor and resource of knowledge for everybody dealing with sufferers with atrial traumatic inflammation, either often perform and in hospitals.

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Does the ECG need to be read by a cardiologist? Cardiologists will offer the most 28 accurate readings of ECGs, but satisfactory interpretations can occasionally be obtained by the general practitioner, the practice nurse, or computerised diagnostic software. • Once somebody has been identified as having AF, should they also receive an echocardiogram to assess their risk of stroke, or is clinical assessment of risk adequate? 3). If the general practitioner notes it to be irregular, they might make a clinical diagnosis of AF, or request an ECG as a confirmatory test.

Valvular heart disease, preexcitatiom syndrome). • Patient with moderate to severe heart failure, or resistant heart failure. • Frequent attacks of paroxysmal AF. • Syncopal attacks due to AF. 2 When to refer a patient with AF to a cardiologist. antithrombotic therapy is still under-used, ranging from 11% to 44% use in those eligible for oral anticoagulants (Sudlow et al, 1995). This is particularly so in elderly patients (over 75 years old) even though the benefits of antithrombotic therapy might be expected to be greatest in those patients.

9 for developing AF in the Framingham study. 42 (Krahn et al, 1995). In that study, either hypertension or ischaemic heart disease preceded AF in 65% of cases, suggesting that both hypertension and ischaemic heart disease accounted for a large proportion of cases of AF. 2 Aetiology of atrial fibrillation amongst acute admissions to a Scottish district general hospital. Reproduced with permission from Lip (1994). some studies from the UK. 2). In particular, hypertension was the most common underlying medical condition in black or Afro-Caribbean patients, whilst in South Asians the most common cause was ischaemic heart disease.

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