All of the following statements about Pulse deficit in Atrial Fibrillation are true , except:
Correct Answer: Radial pulse rate may be more than ventricular pulse rate
Description: Answer is D (Radial pulse rate may be more than ventricular pulse rate) The radial pulse rate is always lower than the ventricular pulse rate. Pulse deficit refers to the difference between the radial pulse rate and the hea rate counted by auscultation (Apical Ventricular Rate). Pulse deficit is produced when ventricular contractions are preceded by sho diastoles such that poor ventricular filling results in insufficient stroke volume to transmit the pressure wave out to the radial pulse. The radial pulse rate is always lower than the ventricular pulse rate. Pulse Deficit in Atrial Fibrillation Atrial fibrillation is the most common cause of pulse deficit (Pulse deficit has traditionally been believed to be a classical bedside sign for diagnosis of atrial fibrillation) Pulse deficit in Atrial Fibrillation is often more than 10 per minute. Pulse deficit in atrial fibrillation is greater when the ventricular rate is high Pulse deficit in atrial fibrillation may be absent in patients with slow ventricular rate (<50) If a digitalized patient with a prior diagnosis of chronic atrial fibrillation presents with a perfectly regular pulse, one should suspect digitalis intoxication with a regular nodal rhythm and atrioventricular dissociation. (Note that in this form of 'regularized' atrial fibrillation, the apical- radial pulse deficit also disappears.)
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