How to Recognize Atrial Fibrillation on an Electrocardiogram

An electrocardiogram (ECG) is an important medical test that is commonly used in cardiovascular care to evaluate the health of a patient’s heart. Individuals who work in the specialty as a technician are often required to perform ECGs and provide an initial evaluation of exam quality as well as identify concerning elements that may exist. Since atrial fibrillation is a relatively common condition, the technician should have a basic understanding of what it is and the effects that it can have on the components of the ECG. While technicians are not typically expected to diagnose or treat patients, their contribution does help to ensure efficiency and improves the quality of care offered to the public.

Atrial fibrillation is an abnormal condition of the heart that is characterized by rapid and irregular beats in the two smaller chambers located above the ventricles. These chambers are responsible for pushing blood into the ventricles before contraction so that the maximum amount of oxygen and nutrients can be delivered to the body. In a normal heart, the rate of atrial contraction is regulated by a collection of nerve fibers known as the sinoatrial node located near the top of the right atrium. The signals that are propagated at this node travel down through the heart along a series of nerve fibers and terminate near the bottom of the left ventricle. This ensures that all of the chambers contract at the appropriate time so that the blood can be forced in the proper direction.

The heart of patients who are suffering from atrial fibrillation is not able to regulate the contractions of the smaller chambers due to electrical signals that roam aimlessly through the atria. It is believed that these signals are produced by a collection of tissues near the pulmonary veins and sustained through a series of re-entry circuits. Fortunately, most of these electrical impulses do not pass through to the right and left ventricles where they could cause ventricular tachycardia or fibrillation. Electrical abnormalities in the ventricles are often life-threatening and would require urgent evaluation and treatment. In many cases, a patient may not even realize that they suffer from atrial fibrillation because of the fact that the atria play a far less significant role in the overall circulation of blood through the vessels.

The electrocardiogram will usually show distinct waveform aberrations in cases where a patient suffers from atrial fibrillation. One of the most telling changes that can be observed is the absence of P waves. The P wave is representative of atrial depolarization and contraction in a healthy heart and tends to be lost in cases where the atria are not contracting in a regular fashion. Other elements that may be seen can include the loss of an isoelectric baseline, fibrillatory waves, ventricular rate variations, irregularities in rhythm, and abnormal QRS complex duration. While it is helpful for a technician to be able to identify these changes and alert licensed personnel to them, most facilities do not allow unlicensed personnel to make formal diagnoses or develop treatment plans.

Individuals who are experiencing this condition might present with a variety of signs and symptoms that often include things like confusion, lightheadedness, fatigue, weakness, chest pain, and more. Although many patients do encounter bothersome symptoms, several individuals are found to have fibrillation in cases where no symptoms were experienced at all. Although a technician is not qualified to evaluate a patient in-depth, they should be aware that the disease can have several different physical signs. These topics and more are generally covered in detail throughout the orientation, training, and certification period that occurs following initial employment.

A rudimentary understanding of the atrial fibrillation ECG is an important part of becoming a successful cardiac care technician and will help individuals make positive contributions to organizational efficiency and the provision of care process. Those who take the time to familiarize themselves with this condition and several others can expect to become a highly valued member of the medical team.