Echocardiogram is another important non-invasive diagnostic tool for AF. This test uses sound waves to produces an image of the heart and helps the cardiologist observe the different regions of the heart and assess their performance. [NIH]
Treatment for AF involves different approaches and may also be decided by the cardiologist depending on the nature of the AF. Paroxysmal AF, which lasts for a short duration (maximum few days) is usually treated with drugs that aim to control the sinus arrhythmia while cases of persistent AF maybe treated either for rhythm control or ventricular rate control. Drugs such as digoxin, (increases contraction and reduces rate) beta-blockers such as atenolol, metoprolol and calcium channel blockers such as verapamil are some of the avilable medications that try to improve the atrial refractory period to control AF. [Josephson, 2003]
Restoration of cardiac rhythm by means of electrical cardioversion is the most common intervention for patients. Since thromboembolism is one of the high risk factors in an AF episode, anticoagulation therapy is part of the treatment. In cases of patients presenting with AF episode lasting more than 12 hours or in whom the duration of arrhythmia is unknown it is advisable to administer anticoagulation therapy for 3 weeks before cardioversion. In cases of emergency, transoesophageal echocardiography prior to cardioversion is a common procedure to check for any thrombi formation in the atrium. A course of anticoagulation therapy should be continued after cardioversion to eliminate the risk of stroke. [Vias Markides, 2003]
In patients with persistent AF and sick sinus node the electro cardiologist may recommend radio frequency AV node ablation followed by permanent pacemaker implantation. [Josephson, 2003] From the nursing perspective it is essential...
The nurse should also inform the patient about potential toxic effects of some of the drugs so the patient may report such instances promptly. Nurses have to carefully monitor the anticoagulation therapy. Further, nurses have the responsibility to educate the patient about diagnostic tests such as EKG and echo cardiogram. Also, in cases of ablated patients, nurses have to perform neurovascular checks on the region of catheter ablation to ensure no infections develop. As the primary care givers, nurses have to provide both physiological and psychosocial support to the patient. [Joan Della, 2007]
Bibliography
1) Maurits a. Allessie, MD, PhD & Penelope a. Boyden et.al (2001), 'Pathophysiology and Prevention of Atrial Fibrillation', Circulation. 2001;103:769, Available Online at, http://www.circ.ahajournals.org/cgi/content/full/103/5/769
2) NIH, 'Atrial Fibrillation', retrieved Sept 10th 2009, from http://www.nhlbi.nih.gov/health/dci/Diseases/af/af_what.html
3) Vias Markides & Richard J. Schilling, (2003), 'Atrial Fibrillation, Classification, Pathophysiology, Mechanisms and Drug Treatment', Heart. 2003 August; 89(8): 939 -- 943
4) Josephson Linda & McMullen Maureen, (2003), 'Atrial Fibrillation: Beyond Irregularly irregular', Nursing 2003, Available online at, http://findarticles.com/p/articles/mi_qa3689/is_200301/ai_n9182958/
5) Joan Della Rocco, 'Responding to Atrial Fibrillation', Nursing April 2007, Available Online at, http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=707110
6)Lawrence Rosenthal & David D. McManus MD, 'Atrial Fibrillation', Retrieved Sept 2009, from http://emedicine.medscape.com/article/151066-overview
