Triggers to AF include sympathetic or parasympathetic stimulation, bradycardia, tachycardia, atrial premature beats, accessory AV pathways, and acute atrial stretch. After being initiated, atrial fibrillation may be ephemeral (Paroxysmal AF). With the persistence of the triggers and initiators that prompt AF, longer periods will ensue, however AF can persist even in their absence. Persistence in their absence may result from electrical or structural remodeling. The longer AF persists, the more difficult it is to restore sinus rhythm and prevent recurrence (Andadre, …show more content…
Starting at a negative intracellular membrane potential (resting potential), they become positive when fired (depolarized) during phase 0. They then go through a series of repolarization steps to get back to resting potential. This is an automatic process as an increase in time-dependent depolarization currents carried by Na+ or Ca2+ (making the cell interior more positive) or a decrease in repolarization currents carried by K+ (which keep the cell interior negative) causes progressive time-dependent cell depolarization. As a threshold potential is reached, the cells fire, producing electrical impulses that make the heart beat (Wakili 2011). Abnormalities in Ca2+, Na+, and/or K+ contribute to ion channel dysfunction and structural remodeling of AF (Andrade, 2014). Irregular rhythm of contraction of muscles in the atria usually exceed 200-400 bpm in AF (The Pathophysiology, 2017). The AV node is unable to conduct beats that fast, thus it does so spasmodically. This results in an irregular ventricular rhythm, pooling of blood in the heart chambers, and on average 20% decrease in cardiac output (Leach,