Core Content: The Irregular Irregularities of Atrial Fibrillation

The Pulmcast podcast episode delves into the complexities of atrial fibrillation (AFib), particularly within the ICU setting. The speakers discuss the high incidence and mortality rates associated with AFib in critically ill patients, emphasizing the importance of recognizing it as a marker of disease severity. They explore the physiology behind AFib, distinguishing it from sinus tachycardia, and highlight the stroke risk due to blood pooling in the atria. The conversation covers the challenges of determining patient stability, the use of electrical cardioversion, and the debate between rate versus rhythm control strategies. Additionally, the speakers address anticoagulation considerations, common rate control drugs, and the potential role of ablation for patients with heart failure, concluding that AFib management requires a case-by-case approach.