Clinical QuickieCardiac
Atrial Fibrillation
AF is three decisions: stability, symptom/rate-rhythm strategy, and stroke prevention.
Stability comes first
Hypotension, acute HF, ongoing ischemia, syncope, or shock attributable to AF changes the pathway immediately.
Rate vs rhythm is patient-specific
Symptoms, AF duration, HFrEF, blood pressure, comorbidities, and rhythm-control candidacy determine whether rate control alone is enough.
Stroke risk needs its own decision
Use a validated thromboembolic-risk framework plus bleeding-risk review, renal function, age, interactions, and patient factors to guide anticoagulation decisions.
Look for the trigger
Infection, thyroid disease, alcohol, pulmonary disease, ischemia, electrolyte abnormalities, postoperative stress, sleep apnea, and stimulants can contribute.
Want more depth?
Read the Deep Dive