الفهرس 
Physiological Principles of AFOnly 14 pages are availabe for public view
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Abstract
Atrial fibrillation (AF) affects 1–2% of the population, and this figure is likely to increase in the next 50 years. AF is the most common peri-operative tachyarrhythmia and an important predictor of morbidity, prolonged hospitalization, and increased hospital costs in surgical patients undergoing cardiothoracic and non-cardiothoracic procedures. The incidence of perioperative AF in non-cardiac, non-thoracic surgical patients is 0.37%, but most frequently occurs within 3 days of surgery. AF is a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation with consequent deterioration of mechanical function. Anesthesia may per se potentiate the risk of developing arrhythmia in an individual, but more particularly in those susceptible. The possible precipitating factors include: hypoxia, hypercapnia, myocardial infarction, catecholamines, electrolyte abnormalities, acid-base imbalance, drug toxicity and adverse drug reactions. The sudden appearance of any new arrhythmia, regardless of hemodynamic consequences, should be have concern and warrants attention. AF is important to the Anesthetist as it is an indicator of a significant systemic disease (e.g. undiagnosed thyrotoxicosis), the loss of the atrial component to systole may lead to a decrease in cardiac output, an excessive ventricular rate may lead to angina, ischemia, hypotension, pulmonary edema, development of left atrial thrombus leads to systemic embolization, the patient may develop anxiety secondary to palpitations, treatment with digoxin may cause toxicity, particularly in the presence of hypokalaemia, and treatment with warfarin may lead to bleeding complications.