Student learning toolCreated by: Champsedine Arevalo, MAN, RN, EMT
Atrial

Atrial Fibrillation

Chaotic atrial activity with irregularly irregular ventricular response and no discrete P waves.

LEAD II · 25 mm/sAFib

Characteristics

Rate
Variable (often 100–160 if uncontrolled)
Rhythm
Irregularly irregular
P wave
Absent — fibrillatory baseline
QRS
Narrow (unless aberrancy)

Common causes

  • Hypertension
  • Valvular disease
  • CHF
  • Hyperthyroidism
  • Alcohol
  • Sepsis

ACLS treatment

  1. 1Stable: rate control (diltiazem, metoprolol) or rhythm control.
  2. 2Unstable: synchronized cardioversion (start 120–200 J biphasic).
  3. 3Anticoagulation per CHA₂DS₂-VASc.

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