Internal Medicine

Biography

Biography: Seemin Afshan Shiraz

Abstract

The number of  patients with atrial fibrillation is anticipated to increase.The  prevalence of AF increases with age. Its more common in Male gender.AF is more common among Caucasians. Patients with cardiac conditions. like Congestive heart failure , Valvular heart disease, MI and those having Diabetes mellitus,Hypertension are prone to have AF. Pathological changes associated with AF include atrial fibrosis and loss of atrial muscle mass. AF is thought to be triggered by ectopic foci, or the generation of multiple wavelets, that lead to uncoordinated atrial contraction.Ectopic foci are found in the pulmonary veins and elsewhere (e.g. superior vena cava). .Electrical and structural remodelling in the atria may be responsible for progression from paroxysmal to persistent or permanent AF.Typical symptoms of AF include ,Palpitations, Fatigue, Chest pain Dizziness,Syncope,Dyspnoea. AF may also be asymptomatic.Approximately 38% of patients with AF are asymptomatic. AF has serious consequences.Its an independent risk factor for stroke, mortality and heart failure. In the management of AF, its  important  to Identify cause and then to establish a strategy to avoid strokes and to treat symptoms – if there are any. Oral Anticoagulation is the only treatment for AF which improves prognosis. It prevents 60% of strokes in AF and 75% of embolic strokes. It reduces mortality by 25% and 20% of strokes are preventable. All patients with AF and with CHA2DS2 VASc score 1 for male and 2 for females should be considered for anti-coagulation.
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Other measures are rate control, cardioversion and ablate therapy including pace & ablate