Auricular Fibrillation Prognosis

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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