Atrial fibrillation differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Atrial fibrillation must be distinguished from other common atrial arrhythmias. These include:

• Atrial flutter
• Atrial tachycardia
• Atrioventricular nodal reentry tachycardia (AVNRT)
• Multifocal atrial tachycardia
• Paroxysmal supraventricular tachycardia
• Wolff-Parkinson-White syndrome

Diagnosis

• Atrial fibrillation is irregularly irregular, while the other rhythms such as atrial flutter, sinus tachycardia, AV nodal reentry tachycardia in paroxysmal supraventricular tachycardia are all much more regular.
• An atrioventricular nodal reentry tachycardia will often break with either carotid sinus massage or AV nodal blocking agents.
• If the patient has Wolff-Parkinson-White syndrome there may be much more rapid conduction.