Cardiac electrophysiology

1. Establish an Accurate Diagnosis of AF1 ? AF is characterized by replacement of consistent P waves with fibrillatory waves, varying in amplitude, shape, and timing. ? The ventricular response is irregular and frequently rapid when AV nodal conduction is intact. ? In patients with pacemakers, diagnosis of AF may require temporary inhibition of the pacemaker to expose atrial activity. ? AF should be distinguished from 1) atrial flutter, which has regular organized atrial activity with a rate typically between 240 and 320 bpm, 2) multifocal atrial tachycardia, which has 3 or more distinct P waves of vari- able morphology, 3) regular supraventricular tachycardias, such as AV nodal reentry and 4) sinus rhythm (SR) with multiple premature atrial complexes.