Consequences

As a consequence of atrial fibrillation, a decrease in cardiac output may occur because the atria with their pumping function no longer contribute to filling the chambers. In addition, a permanent ventricular tachycardia due to conduction via the AV node can lead to damage of the ventricular muscles, which can lead to heart failure (cardiac insufficiency), for example. Most dangerous, however, is the slowed blood flow in the overstretched atria. Since there is no longer any orderly contraction, there are places where the blood almost stops. This can cause blood clots to form in the atrium, which can lead to strokes or pulmonary embolism.

Atrial flutter diagnosis

The classification of atrial flutter/flicker is important. The risk of complications must be assessed by means of various questions. A high risk exists with other embolisms or strokes in the patient’s history.

The risk of complications is also increased in the case of mitral stenosis as the underlying disease. Other risk factors are high blood pressure, diabetes mellitus and manifest heart failure. The diagnosis of atrial flutter/flicker is made via the clinic (fast, irregular pulse with pulse deficit) and ECG, if necessary long-term ECG.

In the ECG irregular intervals between the QRS complexes are observed. The baseline between the QRS-complexes is characterized by small rashes (flicker waves) (most clearly visible in derivation V1) In addition to the pure diagnosis of the rhythm disturbances, a TEE is usually done to exclude atrial thrombi. In TEE (Trans-oesophageal Echocardiography) an ultrasound probe is inserted into the esophagus up to the level of the atria.

In this way blood clots can be found that have formed.

Is there a permanent or a paroxymal form?
How long do the individual episodes of atrial fibrillation last?
Are there any underlying triggering diseases? And if so, which ones?
What effect does atrial fibrillation have on the circulation?
Is there a risk of a heart related blood clot?

The ECG shows a typical irregular excitation propagation.Thus, the so-called QRS complexes, which stand for a resulting heartbeat, are shown on the ECG at irregular intervals. Characteristic are sawtooth-shaped so-called P-waves, small elevations in front of the actual ECG peak, which show the propagation of excitation in the atrium.