Clinical management of Atrial Fibrillation in Uganda

Clinical Features

Irregular pulse. Acute onset: palpitations, dizziness, fainting, chest pain, shortness of breath. Chronic: often asymptomatic.

Investigations

ECG.

Acute onset, high heart rate, or with heart failure

Treat heart failure. Use digoxin and/or Carvedilol (or Bisoprolol) to reduce heart rate.

Acute onset, high heart rate, NO heart failure

Use atenolol 50 mg to control heart rate.

Chronic but normal heart rate

Treat underlying conditions. Refer to assess indication for anticoagulation with aspirin or warfarin to prevent stroke.