Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with intermittent episodes of palpitations, lightheadedness, and dyspnea. Symptoms are self-limiting, lasting <7 days, with spontaneous termination. Denies syncope, chest pain, or orthopnea. No history of persistent AFib. Documented episodes correlate with ECG findings of irregularly irregular rhythm.
Clinical Examination Findings
Cardiovascular: Irregularly irregular heart rhythm noted on auscultation. Pulse deficit present. S1 and S2 heart sounds audible; no murmurs, rubs, or gallops. Peripheral pulses symmetric. No signs of peripheral edema or jugular venous distension. Lungs: Clear to auscultation bilaterally.
Treatment Protocol
1. Rate control: Beta-blockers or non-dihydropyridine calcium channel blockers. 2. Rhythm control: Consider anti-arrhythmic therapy (Class IC or III) if symptomatic. 3. Stroke prophylaxis: CHA2DS2-VASc score calculated; initiate anticoagulation (DOACs or Warfarin) as indicated. 4. Lifestyle: Alcohol cessation, weight management, and management of underlying comorbidities (HTN, OSA).