Atrial fibrillation physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

History and physical examination for atrial fibrillation

The history of the individual's atrial fibrillation episodes is likely the most important part of the evaluation. Distinctions should be made to those who are entirely asymptomatic when they are in atrial fibrillation (in which case the atrial fibrillation is found as an incidental finding on an electrocardiogram or physical examination) and those who have gross and obvious symptoms due to atrial fibrillation and can pinpoint whenever they go into atrial fibrillation and revert to sinus rhythm.

Detailed history and physical examination are essential to define;

• The presence and nature of symptoms associated with AF
• The clinical type of AF (first episode, paroxysmal, persistent, or permanent)
• The onset of the first symptomatic attack or date of discovery of AF
• The frequency, duration, precipitating factors, and modes of termination of AF
• The response to any pharmacological agents that have been administered
• The presence of any underlying heart disease or other reversible conditions (e.g., hyperthyroidism or alcohol consumption)