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Auricular Fibrillation Prognosis





Category: Uncategorized
Source: Disturbances Of The Heart

The prognosis depends on the condition of the myocardium of the
vagus. If this muscle is intact, and there is no pathologic
condition in the sinus node (which can be proved by the successful
results of treatment), the removal of all toxins that could increase
the activity of the heart, and the administration of digitalis,
which will slow the heart by stimulating the pneumogastric control
of the heart, will produce a cure, temporary, if not permanent.

Although a patient with auricular fibrillation may have been
incapacitated by this heart activity, he may not yet have dilated
ventricles, and the digitalis need perhaps not be long continued. If
on account of some heart strain or some unaccountable cause the
fibrillation recurs, he of course must again receive the digitalis.
If the auricular fibrillation is superimposed, or is followed by
dilated ventricles and decompensation, the prognosis is bad,
although the condition may be improved. In other words, auricular
fibrillation added to these conditions is serious, but still, many
times a patient may be greatly improved by rest, digitalis, careful
diet, proper care of the bowels, etc. If the fibrillation occurs
with or was apparently caused by the dilatation of the ventricles,
the prognosis of improvement may be good. If the dilatation of the
ventricles occurs following auricular fibrillation, the prognosis is
not good.

White [Footnote: White: Boston Med. and Surg. Jour., Dec. 2, 1915.]
after studying 200 heart cases, finds that auricular fibrillation
and alternating pulse, as well as heart block, are more frequent in
men than in women, and both auricular fibrillation and alternating
pulse are more apt to occur after 50 years of age than before.
Auricular fibrillation may occur in hearts which are suffering from
valvular lesions, especially mitral stenosis, and may occur in
syphilitic hearts, in various sclerotic conditions of the heart, and
in hyperthyroidism.

Though disputed, it seems probable that fibrillation may be caused
by the excessive use of tea, coffee and tobacco. Paroxysmal
tachycardias are certainly caused by these substances, and the
conditions of auricular fibrillation and auricular flutter may be
found frequently present if such hearts are carefully examined with
cardiographic instruments.





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