A 73-year-old woman comes to the physician because of a 5-day history of intermittent palpitations. She has no history of syncope or chest pain. She had similar symptoms one year ago and following workup has been treated with daily flecainide since then. She drinks one to two glasses of wine on the weekends. She does not smoke. Her pulse is 71/min and her blood pressure is 134/72 mm Hg. A complete blood count shows no abnormalities. Serum creatinine, electrolytes, and TSH are within normal limits. An ECG is shown. Which of the following is most likely the strongest risk factor for this patient's presentation?

Question

A 73-year-old woman comes to the physician because of a 5-day history of intermittent palpitations. She has no history of syncope or chest pain. She had similar symptoms one year ago and following workup has been treated with daily flecainide since then. She drinks one to two glasses of wine on the weekends. She does not smoke. Her pulse is 71/min and her blood pressure is 134/72 mm Hg. A complete blood count shows no abnormalities. Serum creatinine, electrolytes, and TSH are within normal limits. An ECG is shown.   Which of the following is most likely the strongest risk factor for this patient's presentation?

Quizplus · Accepted Answer

Eductional Objective: Age, independent of comorbidities, is one of the strongest risk factors for atrial fibrillation as age-related change to the atrial myocardium is one of the primary contributors to atrial remodeling.  Left atrial dilation is the other primary contributor to atrial remodeling; therefore, comorbidities that cause left atrial dilation (eg, hypertension, heart failure, mitral valve disease) are also strongly associated with atrial fibrillation.

A 73-Year-Old Woman Comes to the Physician Because of a 5-Day