Etiology

• exacerbation of pulmonary disease (e.g. COPD)
• electrolyte disturbance
• catecholamine surge (e.g. sepsis)

 

Common history

• elderly patients with an acute exacerbation of underlying pulmonary disease (e.g. COPD)
• symptoms related to etiology (e.g. cough, wheeze and shortness of breath)

 

Clinical findings

• typically asymptomatic
• rapid, irregular pulse
• at least 3 distinct P wave morphologies
• atrial rate >100/min

 

Management

• treat the underlying etiology, commonly:
  • COPD exacerbation
    • supplemental oxygen (=/- ventilation)
    • steroids
    • antibiotics
• only if absolutely necessary, venticular rate can be controlled with
  • nondihydropyridine calcium channel blockers (e.g. verapamil, diltiazem)
  • beta-blockers

Content on this page has not been checked for accuracy. The author's credentials have not been confirmed. Always use multiple peer-reviewed scholarly sources and good clinical judgement in your decision making.

The Compendium platform was created by David Kwinter, MD, CCFP(EM).