depotdoug
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depotdoug, February 6,  2020  7:12am EST

Acute AFIB condition and ERoom Cardioversion

This article is interesting to look at. Didn't even know about ACUTE AFIB. 
https://www.practiceupdate.com/content/electrical-vs-pharmacological-cardioversion-for-emergency-department-patients-with-acute-atrial-fibrillation/95974

5 Replies
  • MellanieSAF
    MellanieSAF, February 9,  2020  9:21pm EST

    Doug,

    Acute is a medical term that means: "Of abrupt onset, in reference to a disease. Acute often also connotes an illness that is of short duration, rapidly progressive, and in need of urgent care." (Definition from Medicinenet.com)

    It is not a classification of afib. Afib is one of these categories: Paroxysmal (Intermittent), Persistent (Continuous of 7 days of more), Longstanding Persistent (Continuous of more than a year), or Permanent (a decision by doctor and patient not to try to get out of afib).

    Another term you may see is Chronic, which is another term for Persistent, Longstanding Persistent, or Permanent. The term chronic has fallen out of favor, though surgeons sometimes still use it.

    Mellanie

  • Canada
    Canada, February 10,  2020  1:23pm EST

    Thanks Mellanie for pointing out that acute onset is different from classifications.  However, "acute onset" interested me since I hadn't heard of it either.  For me, the article needed registration so I looked elsewhere and found an NCBI abstract about it.  The Definition (and within that the Diagnosis) was helpful to me since it describes my episodes.  Just beyond halfway mark the abstract also describes the various meds we use with helpful comments including benefits, harns and comparisons.  So that might be of interest too.  One drawback - the article is from 2008 so it would be good to also have something more recent.

    Atrial fibrillation (acute onset)   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907989/

    Definition

    Acute atrial fibrillation is rapid, irregular, and chaotic atrial activity of less than 48 hours' duration. It includes both the first symptomatic onset of chronic or persistent atrial fibrillation, and episodes of paroxysmal atrial fibrillation. It is sometimes difficult to distinguish new-onset atrial fibrillation from previously undiagnosed long-standing atrial fibrillation. Atrial fibrillation within 72 hours of onset is sometimes called recent-onset atrial fibrillation. Definitions of acute atrial fibrillation vary, but for the purposes of this review we have included studies where atrial fibrillation may have occurred up to 7 days previously. By contrast, chronic atrial fibrillation is more sustained, and can be described as paroxysmal (with spontaneous termination and sinus rhythm between recurrences), persistent, or permanent atrial fibrillation. This review deals with people with acute and recent atrial fibrillation who are haemodynamically stable. The consensus is that people who are not haemodynamically stable should be treated with immediate direct current cardioversion. We have excluded studies in people with atrial fibrillation arising during or soon after cardiac surgery. Diagnosis: Acute atrial fibrillation should be suspected in people presenting with dizziness, syncope, dyspnoea, or palpitations. Moreover, atrial fibrillation can contribute to a large number of other non-specific symptoms. Palpation of an irregular pulse is generally only considered sufficient to raise suspicion of atrial fibrillation: diagnosis requires confirmation with ECG. However, in those with paroxysmal atrial fibrillation, ambulatory monitoring may be required.

     Canada

  • depotdoug
    depotdoug, February 10,  2020  1:39pm EST

    Thanks Mellanie, and Canada,

    I should of known about acute. Like I had ACUTE NEPHRITIS kidney disease when I was 9 or 10. 4th grade in elementary school. I believe Acute is better than Chronic. Anyway no more Acute Nephritis. 
    Yeh I was Paroxysmal AFIB and leaning in and out of Persistent AFIB. I'd better check my EP records. I do know AFIB Free since last Cardioversion #3 July 2016 is good.  So far my ABIRATERONE acetate Med tablet + Lupron injections + Prednisone have not caused any cardiac mountain explosions. Yet.

  • MellanieSAF
    MellanieSAF, February 10,  2020  1:43pm EST

    Acute-onset would perhaps have been better and more descriptive in the title. 

    Canada, I didn't sign up at the link Doug provided - I simply copied the title and Googled it and found it at the original source. 

    Doug, Glad you don't have afib, and I hope that continues forever.

    Mellanie

  • depotdoug
    depotdoug, February 10,  2020  2:25pm EST

    3 things Free!  AFIB.  UTI.  SOB. 
    But not mPCa SE free. S.E. = side effects. All of my ADHT hormone meds, injections could or can cause irregular heart rhythm. More so low HR of long QTc. But that is not my problem LHR(my acronym for low HR). My 1st and now 2nd ICD/pacemaker is used to control monitor high out of range HR. I try to watch 👁 ball my FITBIT Blaze and my Apple S4 watch HR  functions while exercising profusely. So far I haven't fallen off the treadmill. Elliptical or Stairmaster Steppin machine. 
    Doug Free!  

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