Atrial fibrillation – transient/reversible factors

Atrial fibrillation – transient/reversible factors

There are several reversible or transient factors which can lead on to atrial fibrillation. Many of these episodes of atrial fibrillation may be self-limited or disappear after the cause is taken care of.

Some of the reversible / transient causes for atrial fibrillation include:

1. Acute alcoholic binge is an important cause of transient atrial fibrillation. Atrial fibrillation in this setting is known as holiday heart syndrome. Though reversible, it can recur in the next binge!
2. Cardiac surgery both coronary and valvar, are known to be transient causes of atrial fibrillation. It is more likely in valvar surgery. Atrial fibrillation in this setting can increase stay in the intensive care unit, morbidity, and cost of care.
3. Myocardial infarction is another important cause of transient atrial fibrillation. It may be an indicator of atrial infarction. AF in myocardial infarction can be due to atrial stretch in left ventricular dysfunction.
4. Atrial fibrillation is also the commonest sustained arrhythmia following non-cardiac surgery. Perioperative sympathetic surge, electrolyte imbalances and use of supports are important factors to be considered.
5. Acute myocarditis and pericarditis can cause transient atrial fibrillation. Inflammation of atrial and myocardium and atrial stretch due to left ventricular dysfunction have to be thought of.
6. Atrial fibrillation in acute pulmonary embolism can be due to atrial stretch as well as due to the hyperadrenergic state.
7. Atrial fibrillation is a well-known association of hyperthyroidism. It was thought that there is a higher chance of thromboembolism in this scenario, though the evidence is not conclusive.
8. Electrocution can cause both atrial fibrillation and ventricular fibrillation. This occurs when the shock falls in the vulnerable phase of repolarization.