Atrial fibrillation pulmonary diseases
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Sinus rhythm  |
Atrial fibrillation  | |
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| ICD-10 | I48 |
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| ICD-9 | 427.31 |
| DiseasesDB | 1065 |
| MedlinePlus | 000184 |
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Atrial Fibrillation Microchapters | |
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Atrial fibrillation pulmonary diseases On the Web | |
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Directions to Hospitals Treating Atrial fibrillation pulmonary diseases | |
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Risk calculators and risk factors for Atrial fibrillation pulmonary diseases | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.
Synonyms and related keywords: AF, Afib, fib
Overview
In patients with COPD, supraventricular arrhythmias, including atrial fibrillation are common.[1][2] In patients with acute exacerbations of COPD, the presence of AF has shown to have worst prognosis.[3] The first step in the management is to treat the underlying lung disease and correct hypoxia and acid-base imbalance. Theophylline and beta adrenergic agonists, which are commonly used to relieve bronchospasm, may precipitate atrial fibrillation. In patients with bronchospasm, beta blockers, sotalol, propafenone, and adenosine are contraindicated. Non-dihydropyridine calcium channel blocker and intravenous flecainide[4] may be used to restore sinus rhythm. However, in hemodynamically unstable patients direct-current cardioversion may be attempted. In patients refractory to drug therapy, AV nodal ablation and ventricular pacing may be necessary to control the ventricular rate.
2011 ACCF/AHA/HRS Guidelines for the Management of Atrial Fibrillation- Pulmonary Diseases (DO NOT EDIT) [5][6]
| Class I |
| "1. Correction of hypoxemia and acidosis is the recommended primary therapeutic measure for patients who develop AF during an acute pulmonary illness or exacerbation of chronic pulmonary disease. (Level of Evidence: C) " |
| "2. A nondihydropyridine calcium channel antagonist (diltiazem or verapamil) is recommended to control the ventricular rate in patients with obstructive pulmonary disease who develop AF. (Level of Evidence: C) " |
| "3. Direct-current cardioversion should be attempted in patients with pulmonary disease who become hemodynamically unstable as a consequence of AF. (Level of Evidence: C) " |
| Class III (Harm) |
| "1. Theophylline and beta-adrenergic agonist agents are not recommended in patients with bronchospastic lung disease who develop AF. (Level of Evidence: C) " |
| "2. Beta blockers, sotalol, propafenone, and adenosine are not recommended in patients with obstructive lung disease who develop AF. (Level of Evidence: C)" |
Vote on and Suggest Revisions to the Current Guidelines
Guideline Resources
- 2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation [6]
- ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter [7]
References
- ↑ Shih HT, Webb CR, Conway WA, Peterson E, Tilley B, Goldstein S (1988) Frequency and significance of cardiac arrhythmias in chronic obstructive lung disease. Chest 94 (1):44-8. PMID: 2454781
- ↑ Hudson LD, Kurt TL, Petty TL, Genton E (1973) Arrhythmias associated with acute respiratory failure in patients with chronic airway obstruction. Chest 63 (5):661-5. PMID: 4122207
- ↑ Fuso L, Incalzi RA, Pistelli R, Muzzolon R, Valente S, Pagliari G et al. (1995) Predicting mortality of patients hospitalized for acutely exacerbated chronic obstructive pulmonary disease. Am J Med 98 (3):272-7. PMID: 7872344
- ↑ Barranco F, Sanchez M, Rodriguez J, Guerrero M (1994) Efficacy of flecainide in patients with supraventricular arrhythmias and respiratory insufficiency. Intensive Care Med 20 (1):42-4. PMID: 8163757
- ↑ 5.0 5.1 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114 (7):e257-354. DOI:10.1161/CIRCULATIONAHA.106.177292 PMID: 16908781
- ↑ 6.0 6.1 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2011) 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 123 (10):e269-367. DOI:10.1161/CIR.0b013e318214876d PMID: 21382897
- ↑ Estes NA, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS et al. (2008) ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation): developed in collaboration with the Heart Rhythm Society. Circulation 117 (8):1101-20. DOI:10.1161/CIRCULATIONAHA.107.187192 PMID: 18283199
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