Question:

Once someone has been diagnosed with atrial fibrillation what tests should we carry out?

16 June 2008 note: This question is over 2 years old and may differ to any new research.

CKS have a guideline on AF [1], they report:

“What investigations are required following a diagnosis of AF?

The following investigations are usually possible to arrange in primary care:

Electrocardiography (ECG)
 - An ECG should already have been done to confirm the diagnosis (see Diagnosis).
 - An ECG may also indicate a possible underlying cause (e.g. an old myocardial infarction, left ventricular hypertrophy, or a pre-excitation syndrome) [Fuster et al, 2006].

Blood tests
 - Full blood count — to exclude anaemia, which may worsen rate control and aggravate symptoms
 - Blood chemistry — to exclude electrolyte disturbances, which may precipitate AF and increase toxicity of drugs (e.g. digoxin)
 - Thyroid function tests — to exclude hyperthyroidism
 - Coagulation screen — to assess suitability for warfarin
 - Liver function tests — to assess suitability for warfarin, and to establish a baseline prior to treatment with potentially toxic drugs such as amiodarone [MeReC, 2002]

Chest radiograph (X-ray)
- May be useful for some people, for example if there is clinical suspicion of pulmonary pathology (e.g. lung cancer) or heart failure [Fuster et al, 2006]”

The guideline also discusses other tests, normally carried out in secondary care.

Reference

1) http://cks.library.nhs.uk/atrial_fibrillation/view_whole_topic
 

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