A irregularly irregular rhythm varying from bradyarrhythmia to tachyarrhythmia. Etiologies include ischemia, atrialdilation, surgery, pulmonary disease, thyrotoxicity, alcohol intoxication. Symptoms: palpitation, fatigue, dizziness,hypotension, syncope, tachycardia. Cardiac auscultation revealing irregularly irregular rhythm.Etiology* Coronary artery disease*MS, MR, AS, AR* Thyrotoxicosis* Pulmonary embolism, COPD* Pericarditis* Myocarditis, cardiomyopathy* Tachycardia-bradycardia syndrome* Alcohol abuse*Ml* WPW syndrome* Other causes: left atrial myxoma, atrial septal defect, carbon monoxide poisoning, pheochromocytoma, idiopathicWorkupNew-onset atrial fibrillation: ECG echocardiogram Holter monitor, and laboratory evaluation.Note irregular fibrillatory waves (f).Treatment* Vagal maneuver or ice water immersion, or carotid massage (avoid it doing billateraly and in patients with catoridbruits)* If vagal maneuvers fail, do rapid IV infusions of adenosine, or calcium channel blockers (do not use verapamil in.

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Atrial fibrilation .-::70619::-.