Chaotic multiple atrial depolarisations (not originating in SA node) leading to AF - no effective atrial contraction. Therefore no discrete p-waves will be seen and ventricular depolarisations will occur irregularly

• May be acute, paroxysmal, persistent or permanent
  • paroxysmal: more than 30 seconds and resolving within 7 days

In AF the conduction isnt coming from the SA node, there’s just repetitive twitching from all around the atria, sometimes one of these makes it through which causes a ventricular contraction - irregularly irregular

Epidemiology:

• It is very common, being present in around 5% of patients over aged 70-75 years and 10% of patients aged 80-85 years.
• 1/3 of patients post cardiac surgery develop AF

Reversible causes of AF:

• Sepsis
• Mitral Valve Pathology (stenosis or regurgitation)
• Ischemic Heart Disease
• Thyrotoxicosis
• Hypertension
• alcohol, caffeine, substance misuse

PC:

Patients are often asymptomatic and incidentally picked up when attending for other reasons.

Presenting symptoms can be:

• Palpitations