Figure 1. Normal Sinus Rhythm and Two Types of Atrial Fibrillation. Images courtesy of ECGGuru.com.

Figure 1. Normal Sinus Rhythm and Two Types of Atrial Fibrillation. Images courtesy of ECGGuru.com.

By Sylvia Foley, AJN senior editor

Atrial fibrillation, the most common chronic cardiac arrhythmia, affects an estimated three to six million Americans and can profoundly diminish their quality of life. Treatment guidelines for atrial fibrillation are frequently updated—a fact that “speaks to both the prevalence and the serious health care implications of the condition,” says Christine Cutugno, an experienced critical care nurse and educator. It can take time to determine just what has changed. She offers nurses ample guidance in one of this month’s CEs, “Atrial Fibrillation: Updated Management Guidelines and Nursing Implications.” Here’s a brief overview.

Atrial fibrillation is frequently associated with advancing age, structural cardiac dysfunction, and preexisting comorbidities. The most common complications, stroke and heart failure, result in significant morbidity and mortality. Indeed, atrial fibrillation is responsible for over 450,000 hospitalizations and 99,000 deaths annually and adds up to $26 billion to U.S. health care costs each year. Given the aging of the U.S. population, the incidence of atrial fibrillation is expected to double within the next 50 years. There is evidence that nursing intervention in patient education and transition of care coordination can improve adherence to treatment plans and patient outcomes.

This article reviews the recently updated guideline for the management of atrial fibrillation, issued jointly by the American Heart Association, the American College of Cardiology, and the Heart Rhythm Society. It focuses on the prevention of thromboembolism and on symptom control, and stresses the importance of patient adherence to treatment plans in order to ensure better outcomes.

Nursing implications. Cutugno notes that both care coordination among providers and sustained follow-up care with patients are crucial, adding that “instructions delivered just once by a harried staff nurse or medical resident don’t begin to meet patient education needs.” She discusses recent research findings that support the use of care pathways and nurse-led follow-up care. To learn more, read the article, which is free online.

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