Nursebob’s MICU/CCU Survival Guide
Cardiology In Critical Care
Arrhythmia Recognition
Atrial Fibrilation
Nursebob
2/6/2006 ©
1. Impulses originate in multifocal atrial pacemaker.
A. Rate 300-600/min
B. Only some of them are conducted to the ventricles.
C. Atrial activity is represented by numerous, irregularly spaced small deflections of varying configuration.
a. F waves) best seen in L2, L3 AVF and V1.
b. Occasionally, f waves may be prominent ("coarse" fibrillation) resembling atrial flutter or no atrial activity is discernible ("fine" fibrillation). c. Only some f waves pass through the AV junction and activate ventricles in a completely irregular fashion.
D. Vagal stimulation may have no effect or may slow the ventricular rate by increasing the AV block.
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