April 2025

Peer Reviewed Feature Articles
Arrhythmias

Atrial fibrillation: management in patients with heart failure

Gregory Harvey, Hariharan Raju

Atrial fibrillation is the most common sustained arrhythmia and often coexists with heart failure. A combined focus on the general principles of management of atrial fibrillation alongside a complex decision regarding suitability and preference for rhythm control is required. Interventional approaches also improve survival and reduce symptom burden in people affected by both conditions.

Peer Reviewed Regular Series
ECG education

FitBit and an irregular pulse

Vivienne Miller

A 77-year-old woman has recently been wearing a FitBit that has shown her pulse to be irregular and alerting her to frequent alarms. She is feeling well, but when you feel her pulse it is irregularly irregular. You organise an ECG but the paper runs out before you can print the rhythm strip. What does the ECG show and what are the possible diagnoses?

Physician-authored summaries and commentary on the most important medical research, provided by the NEJM Group, a division of the Massachusetts Medical Society.

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