Abstract
Atrial fibrillation (AFib) is the most common sustained cardiac arrhythmia and carries important therapeutic implications, particularly regarding anticoagulation and stroke prevention. However, AFib remains frequently misdiagnosed, often due to overreliance on automated electrocardiogram (ECG) interpretations and failure to recognize alternative causes of rhythm irregularity. This review highlights the fundamental ECG characteristics required for the diagnosis of AFib and emphasizes that not all irregular rhythms represent atrial fibrillation. Through a representative clinical case and discussion of common mimickers—including Mobitz I (Wenckebach) atrioventricular block, premature atrial contractions, blocked premature atrial contractions, multifocal atrial tachycardia, and sinus arrhythmia—we demonstrate key electrocardiographic features that distinguish these rhythms from true AFib. Careful ECG review and clinical judgment remain indispensable for accurate rhythm interpretation and prevention of unnecessary treatments and associated complications.
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Recommended Citation
Jasty T, Jyothi Ramachandran Nair D. Mimickers of Atrial Fibrillation: When all Irregular Rhythms Are Not Atrial Fibrillation. Transformative Medicine. 2026; 5(2):23-26. doi: https://doi.org/10.54299/tmed/nyib8128.