Cardiac causes of AF/AFL, as described in the Framingham Heart Study, include mitral valve disease, myocardial disease, conduction system disorders, Wolff-Parkinson-White syndrome, and pericardial disease.13 Conditions associated with AF include thyrotoxicosis, hypothermia, alcohol use, severe infection, hypoxia, pulmonary emboli and pneumonia, kidney disease, obesity, diabetes mellitus, digoxin toxicity, and electrolyte abnormalities.20-22 Intrathoracic surgery, such as cardiac or pulmonary surgery, or invasive cardiac studies may also precipitate AF.23
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