Atrial fibrillation

Congratulations, your atrial fibrillation has passed…

I happily exclaim on entering the patient’s room on morning rounds, “Good news, your heart rhythm is regular, the atrial fibrillation is gone!”

“Converted at 0230 this am,”  he says in a fatigued voice.

I ask, “How do you know it was 0230?”

He tells me, “Because the nurse came in, flipped on the lights, woke me up and told me I converted.”

This brings a grin, but of course one cannot help but think, why would a nurse think this was worthy of waking someone whose disease is often precipitated by poor sleep?

Who knows for sure, but a logical guess is simply the vastness and complexity of atrial fibrillation.  It afflicts so many and the manifestations, natural history and prognosis are so varied.  A humbling disease that requires much objective knowledge but also a fair amount of ability in “mastering the obvious.”

Although most other arrhythmias are cured with a singular ablation lesion, AF “cure” remains elusive and likely will for many years to come.