![]() ![]() This may not be so factual in patients with A Fib who often note that they have a very uncomfortable heart palpatation regardless of the rate. Remember rate-related symptoms may be uncommon if heart rate is < 150 bpm. First, quickly recognizing that the patient has significant symptoms and is unstable, and second, quickly recognizing that the patient's signs and symptoms are caused by the tachycardia. Furthermore AHA recommends two key concerns when managing patients with unstable tachycardia. According to the American Heart Association, (AHA 2010-15), the stable versus unstable criteria is determined based on the patient’s arrthymia causing clinical features. Purpose: The purpose of this clinical update is to promote best nursing practice in the emergent treatment of the stable versus unstable patient population with atrial fibrillation per the 2015 Advanced Cardiac Life Support (ACLS) guidelines by the American Heart Association.ĭiscussion: During atrial fibrillation the atria fires off at a rate of 350-600 beats per minute making the patient uncomfortable and symptomatic. Atrial fibrillation as an emergent clinical presentation requires expert consultation from a cardiologist, intensivist and acute care and or emergency medical practitioner. Atrial fibrillation can lead to stasis of blood that can bring forth clot formation in the atria with potential for embolization and stroke (Nijjer and Lefroy, 2012). The synchronized atrial contraction and relaxation is replaced by uninterrupted mechanically ineffective ventricular responses. On an electrocardiogram a ‘P’ wave is not seen during the chaotic electrical activity. Disorganized electrical activity starts from rapidly firing electrical active atrial foci. "Atrial fibrillation (AF) is independently associated with a higher risk of morbidity and mortality, in particular with an increased risk of thromboembolic events", (Proietti, Antoniazzi, Manzani, Santalucia, & Franchi, 2018). It is a serious medical condition, which shows a loss of controlled atrial movement with an irregularly irregular ventricular rate. Problem, Patient and or Population Review of the Literature:"Atrial fibrillation (AF) is the most common arrhythmia presentation to the emergency department and frequently results in admission to the hospital", (Gilbert, Angaran, Mariano, Aves & Dorian, 2017). Valdes DNP, MSN-HCS, RN-BC Roxana Orta DNP, MSN Ed., ARNP-BC Ruth Everett-Thomas Ph.D, RN, RT, Beatriz Valdes Ph.D., MBA, RN, & Ann Graziotti, DNP,MSN, ARNP-BC ![]()
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