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									<p>La fibrilación auricular es una arritmia cardíaca muy común que suele provocar latidos rápidos e irregulares.</p><p>Esta arritmia se produce con mayor frecuencia en personas mayores y en personas con problemas estructurales del corazón, como enfermedades valvulares, insuficiencia cardíaca o trastornos de la conducción eléctrica cardíaca.</p><script async src="https://pagead2.googlesyndication.com/pagead/js/adsbygoogle.js?client=ca-pub-4254951495333536" 
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</script><p>La fibrilación auricular afecta a alrededor del 0,5% de la población general y del 2 al 5% de los individuos mayores de 65 años.</p><p>El mayor problema de la fibrilación auricular no es la arritmia en sí, sino el alto riesgo de formación de trombos en el interior del corazón, que pueden desprenderse, viajar al cerebro y provocar un ictus.</p><p>El aleteo auricular (también llamado flutter auricular) es un proceso muy similar a la fibrilación auricular. La información contenida en este texto es útil para ambas arritmias.</p>								</div>
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									<h2 class="wp-block-heading"><span id="Que_es_la_auricula">¿Qué es la aurícula?</span></h2><p>Aquí repasaremos brevemente la anatomía del corazón para poder entender mejor la fibrilación auricular.</p><p>Nuestro corazón tiene cuatro cámaras o cavidades: aurícula izquierda, ventrículo izquierdo, aurícula derecha y ventrículo derecho. El lado izquierdo del corazón, compuesto por la aurícula y el ventrículo izquierdo, no tiene comunicación con el lado derecho del corazón, compuesto por la aurícula y el ventrículo derecho.</p>								</div>
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									<p>La sangre circula por el corazón siguiendo los siguientes pasos:</p><ul><li>La sangre del cuerpo llega al corazón a través de la vena cava, que desemboca en la aurícula derecha (flechas azules).</li><li>Cuando la aurícula está llena, se contrae y empuja la sangre hacia el ventrículo derecho.</li><li>Del mismo modo, cuanto el ventrículo se llena, se contrae, bombeando la sangre hacia las arterias pulmonares.</li><li>La sangre pasa entonces por los pulmones, recibe oxígeno y vuelve al corazón a través de la aurícula izquierda (flechas rojas).</li><li>De nuevo, cuando la aurícula se llena, se contrae y empuja la sangre hacia el ventrículo izquierdo.</li><li>El ventrículo izquierdo, cuando está lleno, bombea la sangre hacia la aorta, desde donde se distribuirá al resto del cuerpo.</li><li>Tras circular por todo el cuerpo, la sangre vuelve al corazón a través de la vena cava, reiniciando el ciclo.</li></ul>								</div>
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									<h2 class="wp-block-heading"><span id="Que_es_una_arritmia_cardiaca">¿Qué es una arritmia cardíaca?</span></h2><p>Todo este proceso de contracción del corazón y de bombeo de la sangre está finamente sincronizado, de modo que cada acontecimiento descrito anteriormente se produce con un intervalo de sólo centésimas de segundo.</p><p>La contracción del corazón está controlada por ligeros impulsos eléctricos generados por una estructura llamada nodo sinusal, situada en el vértice de la aurícula derecha, que está formada por células capaces de generar actividad eléctrica. Si quiere comprender mejor el funcionamiento de la actividad eléctrica cardíaca, lea: Electrocardiograma (ECG): comprenda los resultados.</p><p>Las arritmias cardíacas son trastornos que surgen cuando hay un problema en la generación o distribución de estos impulsos eléctricos por parte del corazón, haciendo que la contracción de las cavidades cardíacas pierda ese sincronismo descrito anteriormente.</p>								</div>
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									<h2 class="wp-block-heading"><span id="Que_es_la_fibrilacion_auricular">¿Qué es la fibrilación auricular?</span></h2><p>Normalmente, los impulsos eléctricos cardíacos son generados únicamente por el nódulo sinusal, estimulando la contracción primero de la aurícula derecha, luego de la izquierda y finalmente de los ventrículos. Un solo impulso eléctrico tarda 0,19 segundos en recorrer todo el corazón.</p><p>Durante la actividad cardíaca normal, el nódulo sinusal dispara rítmicamente impulsos eléctricos, con un intervalo mínimo entre cada nuevo impulso. No tiene sentido que el corazón genere dos o más impulsos eléctricos simultáneos, porque el músculo cardíaco necesita unas décimas de segundo para recuperarse y volver a contraerse.</p><p>La fibrilación auricular es una arritmia causada por la aparición en las aurículas de más de un punto capaz de desencadenar impulsos eléctricos. Cuando hay varios impulsos eléctricos que se disparan simultáneamente, de forma caótica, los músculos de las aurículas reciben varias órdenes de contraerse simultáneamente, sin tiempo de descanso, lo que les impide funcionar correctamente.</p>								</div>
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									<p>En esta arritmia, las aurículas realizan contracciones cortas, sucesivas e ineficaces. Visualmente parecen temblar, como si recibieran una descarga eléctrica o tuvieran una convulsión. La aurícula normal late entre 60 y 100 veces por minuto, que es la frecuencia cardíaca normal. En la fibrilación auricular puede realizar hasta 600 contracciones (cortas e ineficaces) por minuto.</p><p>Por suerte, estos impulsos eléctricos caóticos no pueden llegar a los ventrículos, porque tienen que pasar por una estructura llamada nodo auriculoventricular (nodo AV).</p><p>El nodo AV, situado en la frontera entre las aurículas y los ventrículos, es capaz de filtrar los cientos de impulsos caóticos que llegan, permitiendo el paso de sólo 100 a 170 impulsos por minuto (lo que provoca una frecuencia cardíaca de 100 a 170 latidos por minuto).</p><p>El paciente con fibrilación auricular tiene un corazón acelerado, pero a diferencia de la aurícula, hay un intervalo mínimo entre un impulso y otro, de modo que los ventrículos mantienen intacta su capacidad de contracción.</p><p>Como la aurícula en fibrilación no se contrae correctamente, el paso de la sangre al ventrículo se ve afectado y no se produce de forma lineal. La sangre acaba creando una turbulencia en el interior de la aurícula, lo que hace que parte de ella se represe, favoreciendo la formación de coágulos en su interior (más adelante explicaré las consecuencias de estos coágulos).</p>								</div>
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									<h2 class="wp-block-heading"><span id="Causas">Causas</span></h2><p>La edad es uno de los factores de riesgo más importantes, siendo la fibrilación auricular una arritmia muy común en las personas mayores. En más del 70% de los casos de fibrilación auricular, el paciente tiene más de 65 años. Por otro lado, sólo el 0,1% de la población menor de 55 años tiene fibrilación auricular.</p><p>Además de la edad, otro factor de riesgo importante es la presencia de enfermedades del corazón; la hipertensión arterial y las enfermedades coronarias son las dos más importantes.</p><p>El paciente hipertenso de larga duración suele tener las aurículas dilatadas, lo que favorece la desregulación del sistema eléctrico cardíaco. El paciente con enfermedad coronaria puede presentar isquemia de los tejidos y de las células que generan y conducen los impulsos eléctricos, favoreciendo la aparición de arritmias.</p>								</div>
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									<p>También son factores de riesgo para el desarrollo de la fibrilación auricular:</p><ul><li>Insuficiencia cardíaca.</li><li>Enfermedades de las válvulas del corazón.</li><li>Hipertiroidismo.</li><li>Consumo excesivo de alcohol.</li><li>Apnea obstructiva del sueño.</li><li>Enfermedad pulmonar obstructiva crónica.</li><li>Obesidad.</li><li>Infecciones agudas.</li><li>Embolia pulmonar.</li><li>Drogas y medicamentos.</li><li>Consumo excesivo de cafeína (a dosis habituales no hay evidencia de riesgo).</li></ul>								</div>
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									<h2 class="wp-block-heading"><span id="Sintomas">Síntomas</span></h2><p>Si la fibrilación auricular no provoca una aceleración significativa de los latidos del corazón, llamada taquicardia, puede pasar desapercibida.</p><p>Sin embargo, en muchos casos, la fibrilación auricular suele ir acompañada de frecuencias cardíacas de entre 120 y 140 latidos por minuto, lo que provoca síntomas como palpitaciones, molestias en el pecho, mareos, cansancio y/o dificultad para respirar. En estos casos, decimos que el paciente tiene una <strong>fibrilación auricular de alta respuesta ventricular</strong>.</p><p>Además de un corazón acelerado, por encima de las 100 pulsaciones por minuto, el ritmo de los latidos es irregular.</p><p>Si experimenta palpitaciones o alguno de los síntomas de fibrilación auricular mencionados anteriormente, ponga el dedo en su propia muñeca para evaluar sus latidos. Un corazón normal late regularmente, con intervalos de tiempo iguales entre cada latido. La frecuencia cardíaca suele estar entre 60 y 100 latidos por minuto.</p><p>Si el paciente ya padece una cardiopatía isquémica, la taquicardia puede agravar la isquemia, provocando una angina de pecho o incluso un infarto de miocardio.</p>								</div>
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									<h2 class="wp-block-heading"><span id="Complicaciones">Complicaciones</span></h2><p>El gran problema de la fibrilación auricular es el aumento del riesgo de ACV (ictus). Como la aurícula no se contrae correctamente, la sangre puede crear una especie de remolino en su interior, lo que favorece la aparición de coágulos.</p><p>Si uno de estos coágulos formados salir de la aurícula izquierda, llegará a la aorta y será lanzado directamente para algún punto del cuerpo (los coágulos lanzados en la circulación se denominan émbolos).</p><p>Si este émbolo procedente del corazón sube hacia el cerebro, así que llegar a una arteria más fina, con un diámetro menor que el suyo, se atascará, obstruyendo inmediatamente la llegada de sangre a través de esta arteria, provocando así una isquemia en parte del cerebro.</p><p>El émbolo también puede ir a otras partes del cuerpo y causar trombosis e isquemia en los ojos, los riñones, los intestinos, la columna vertebral o incluso en los dedos de los pies, si el émbolo es muy pequeño y consigue viajar a las extremidades del cuerpo sin atascarse primero.</p>								</div>
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									<h2 class="wp-block-heading"><span id="Tipos">Tipos</span></h2><p>La fibrilación auricular se clasifica de 4 maneras: recién diagnosticada, paroxística, persistente o permanente.</p><h3 class="wp-block-heading"><span id="Fibrilacion_auricular_recien_diagnosticada">Fibrilación auricular recién diagnosticada</span></h3><p>Toda la fibrilación auricular cuando se detecta por primera vez se clasifica como recién diagnosticada. En algunas situaciones, basándose en los síntomas de las palpitaciones, es posible determinar el momento exacto de su aparición.</p><p>Sin embargo, hay casos de fibrilación auricular asintomática, lo que hace que muchos pacientes tengan la arritmia y no lo sepan. Estos casos suelen descubrirse accidentalmente durante un examen médico rutinario.</p><h3 class="wp-block-heading"><span id="Fibrilacion_auricular_paroxistica">Fibrilación auricular paroxística</span></h3><p>Se trata de pacientes con episodios recurrentes de fibrilación auricular de corta duración. Por lo general, el paciente presenta al menos dos episodios por semana, con una duración inferior a 24 horas y con resolución espontánea.</p><h3 class="wp-block-heading"><span id="Fibrilacion_auricular_persistente">Fibrilación auricular persistente</span></h3><p>Estos son los casos que no desaparecen espontáneamente y necesitan ser tratados con fármacos antiarrítmicos o cardioversión eléctrica para ser revertidos (explicaré el tratamiento más adelante).</p><h3 class="wp-block-heading"><span id="Fibrilacion_auricular_permanente">Fibrilación auricular permanente</span></h3><p>Son los casos de fibrilación auricular que duran más de un año y no desaparecen espontáneamente ni con tratamiento médico.</p>								</div>
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									<h2 class="wp-block-heading"><span id="Diagnostico">Diagnóstico</span></h2><p>El diagnóstico de la fibrilación auricular se hace fácilmente a través de electrocardiograma.</p><p>En casos de fibrilación auricular paroxística, un examen llamado Holter puede ser necesario. En este examen, el paciente se queda con un aparato de electrocardiograma en su cuerpo durante 24 a 48 horas, siendo posible detectar la aparición de períodos cortos de FA a lo largo de este intervalo de tiempo.</p><p>El ecocardiograma (un tipo de ultrasonido del corazón) también es capaz de detectar la fibrilación auricular. Su gran ventaja es que también puede evaluar el tamaño de los ventrículos y de las aurículas. Pacientes con corazón muy dilatado generalmente no responden bien a los tratamientos que pretenden revertir la fibrilación auricular.</p>								</div>
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									<h2 class="wp-block-heading"><span id="Tratamiento">Tratamiento</span></h2><p>El tratamiento de la fibrilación auricular puede tener tres líneas de acción:</p><ul><li>Revertir la fibrilación.</li><li>No revertir la fibrilación, pero controlar la frecuencia cardíaca.</li><li>Impedir la formación de coágulos dentro de las aurículas.</li></ul>								</div>
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<h4 class="pt-cv-title"><a href="https://prevencionsaludproactiv.com/2022/02/24/riesgo-electrico/" class="_blank" target="_blank" >Riesgo Eléctrico</a></h4>
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<h4 class="pt-cv-title"><a href="https://prevencionsaludproactiv.com/2022/02/24/primeros-auxilios-2/" class="_blank" target="_blank" >Primeros Auxilios</a></h4>
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<h4 class="pt-cv-title"><a href="https://prevencionsaludproactiv.com/2022/02/20/rcp-solo-con-las-manos/" class="_blank" target="_blank" >RCP Solo con las Manos</a></h4>
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<h4 class="pt-cv-title"><a href="https://prevencionsaludproactiv.com/2022/01/18/maniobra-de-heimlich-charla-de-seguridad/" class="_blank" target="_blank" >Maniobra de Heimlich</a></h4>
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<div class="pt-cv-content">El aumento del estrés, el estilo de vida sedentario, el ...<br /><div class="pt-cv-rmwrap"><a href="https://prevencionsaludproactiv.com/2021/12/07/importancia-de-tener-un-dea-en-el-lugar-de-trabajo/" class="_blank pt-cv-readmore btn btn-success" target="_blank">Leer Más</a></div></div></div></div>
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<h4 class="pt-cv-title"><a href="https://prevencionsaludproactiv.com/2021/12/07/ley-numero-21-156-desfibriladores-dea/" class="_blank" target="_blank" >Ley N° 21.156 Desfibriladores (DEA)</a></h4>
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<h4 class="pt-cv-title"><a href="https://prevencionsaludproactiv.com/2021/11/19/escala-de-eva-en-enfermeria/" class="_blank" target="_blank" >Escala de EVA en Enfermería</a></h4>
<div class="pt-cv-content">La escala del dolor EVA en enfermería (Escala Visual Analógica), ...<br /><div class="pt-cv-rmwrap"><a href="https://prevencionsaludproactiv.com/2021/11/19/escala-de-eva-en-enfermeria/" class="_blank pt-cv-readmore btn btn-success" target="_blank">Leer Más</a></div></div></div></div>
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<h4 class="pt-cv-title"><a href="https://prevencionsaludproactiv.com/2021/11/18/estados-de-inconsciencia/" class="_blank" target="_blank" >Estados de Inconsciencia</a></h4>
<div class="pt-cv-content">Estado de inconsciencia El estado o situación en que una ...<br /><div class="pt-cv-rmwrap"><a href="https://prevencionsaludproactiv.com/2021/11/18/estados-de-inconsciencia/" class="_blank pt-cv-readmore btn btn-success" target="_blank">Leer Más</a></div></div></div></div>
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<h4 class="pt-cv-title"><a href="https://prevencionsaludproactiv.com/2021/11/03/conducta-pas/" class="_blank" target="_blank" >Conducta PAS</a></h4>
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Fibrilación Auricular y Riesgo de Ictus
