Epidemiology and etiologies-atrial fibrillation

(Circ A&E 2018;11:e006350)

• 1–2% of pop. has AF (10% of those age ≥80); M >F; lifetime risk ~25%; mean age 75 y

Acute (up to 50% w/o identifiable cause)

• Cardiac:
  • HF, new CMP, myo/pericarditis, ischemia/MI, HTN crisis,
  • valve dis., cardiac surg
• Pulmonary:
  • acute pulmonary disease or hypoxemia (eg, COPD flare, PNA),
  • PE, OSA
• Metabolic:
  • high catecholamine states (stress, infection, postop, pheo),
  • thyrotoxicosis
• Neurogenic:
  • subarachnoid hemorrhage,
  • ischemic stroke
• Drugs:
  • alcohol, cocaine, amphetamines, smoking, ibrutinib

Chronic:

• ↑ age, HTN, ischemia, valve dis. (MV, TV, AoV), CMP, hyperthyroidism, obesity
• Aggressive mgmt of HTN, OSA & EtOH (NEJM 2020;382:20) to ↓ risk

Explain by ChatGPT

• AF can be asymptomatic or associated with fatigue, dyspnea, palpitations, or chest pain

Epidemiology and etiologies-atrial fibrillation

• 1–2% of the population has AF (10% of those age ≥80);

• Acute (up to 50% w/o identifiable cause)

• Cardiac: HF, new CMP, myo/pericarditis, ischemia/MI, HTN crisis, valve dis., cardiac surg

• Pulmonary: acute pulmonary disease or hypoxemia (eg, COPD flare, PNA), PE, OSA

• Metabolic: high catecholamine states (stress, infection, postop, pheo), thyrotoxicosis

• Drugs: alcohol, cocaine, amphetamines, smoking, ibrutinib

• Neurogenic: subarachnoid hemorrhage, ischemic stroke

• Chronic: ↑ age, HTN, ischemia, valve dis. (MV, TV, AoV), CMP, hyperthyroidism, obesity

• Aggressive mgmt of HTN, OSA & EtOH (NEJM 2020;382:20) to ↓ risk

• AF can be asymptomatic or associated with fatigue, dyspnea, palpitations, or chest pain

窩的英文不太好

• AF 可能沒有症狀或伴有疲勞、呼吸困難、心悸或胸痛

流行病學和病因學——房顫

• 1-2% 的人口患有房顫（其中 10% 的年齡≥80 歲）；

• 急性（高達 50% w/o 可識別原因）

• 心臟：心力衰竭、新 CMP、肌病/心包炎、缺血/心肌梗死、高血壓危象、瓣膜病、心臟外科手術

• 肺部：急性肺部疾病或低氧血症（例如，COPD 發作、PNA）、PE、OSA

• 代謝：高兒茶酚胺狀態（壓力、感染、術後、pheo）、甲狀腺毒症

• 藥物：酒精、可卡因、苯丙胺、吸煙、依魯替尼

• 神經源性：蛛網膜下腔出血、缺血性中風

• 慢性：↑ 年齡、高血壓、局部缺血、瓣膜病。 (MV, TV, AoV), CMP, 甲亢, 肥胖

• HTN、OSA 和 EtOH 的積極管理 (NEJM 2020;382:20) 到 ↓ 風險

• AF 可能沒有症狀或伴有疲勞、呼吸困難、心悸或胸痛