EASY WAY TO REMEMBER: ATRIAL FIBRILLATION

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ATRIAL FIBRILLATION 


WHEN THE ATRIAL MUSCLE FIBRES CONTRACT INDEPENDENTLY THERE ARE NO (P WAVES) ON THE ECG, ONLY AN IRREGULAR LINE.

AT TIMES THERE MAY BE FLUTTER- LIKE WAVES FOR 2-3 SEC.

THE AV NODE IS CONTINUOUSLY BOMBARDED WITH DEPOLARIZATION WAVES OF VARYING STRENGTH  AND DEPOLARIZATION SPREADS AT IRREGULAR INTERVALS DOWN THE HIS BUNDLE.

THE AV NODE CONDUCTS IN AN "ALL (OR) NONE" FORMATION, SO THAT THE DEPOLARIZATION WAVES PASSING INTO THE HIS BUNDLE ARE CONSTANT INTENSITY.

HOWEVER, THESE WAVES ARE IRREGULAR  AND THE VENTRICLES THEREFORE CONTRACT IRREGULARLY.

BECAUSE CONDUCTION INTO AND THROUGH THE VENTRICLES IS BY THE NORMAL ROUTE, EACH QRS COMPLEX IS OF NORMAL SHAPE.

FIBRILLATION WAVES CAN AFTER BE SEEN MUCH BETTER IN SOME LEADS [ 2ND AND V1 ]



NOTE: NO P WAVES.
             IRREGULAR BASELINE. 
             IRREGULAR QRS COMPLEXES, RATE VARYING BETWEEN 75/MIN AND 190/MIN.
             NARROW QRS COMPLEXES OF NORMAL SHAPE.
             DEPRESSED ST-SEGMENTS IN LEADS V5-V6.
             NORMAL T WAVES.

SIMPLE CONCEPT: ABSENT ( P WAVE) - IRREGULAR - ATRIAL FIBRILLATION.
                                    ABSENT ( P WAVE) - REGULAR - SVT

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