Triggers of atrial fibrillation Mnemonic [Easy to remember]

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Triggers of atrial fibrillation Mnemonic

Ah, atrial fibrillation — the cardiac equivalent of your atria screaming “YOLO!” 😀 and firing impulses like bazooka. If your patient’s ECG suddenly looks like it’s trying to perform jazz hands, don’t panic — just remember the mnemonic: PIRATES 🏴‍☠️

Because nothing says chaotic atria like a pirate crashing your sinus rhythm.

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Here’s a classic Afib ECG

Triggers of Atrial Fibrillation Mnemonic

Letter Trigger Explanation
P Pulmonary Embolism Sudden strain on the right heart = electrical chaos. 💥
I Ischaemia Lack of oxygen makes atria cranky. Classic post-MI arrhythmia.
R Respiratory Disease COPD, pneumonia… because lungs and hearts love to bicker. 🌬️😤
A Atrial Enlargement / Myxoma Big atria = more room for mischief. Tumor bonus: surprise AFib. 🏰
T Thyroid Disease (esp. hyperthyroidism) Hyper = heart on espresso. ☕💓
E Ethanol Aka “Holiday Heart Syndrome.” Your atria after that third margarita. 🍸💃
S Sepsis / Sleep Apnoea Systemic stress or nocturnal suffocation — either way, atria revolt. 😴🔥

 

🔍 Clinical Bonus

  • AFib = irregularly irregular rhythm with absent P waves (look above for a classic Afib ECG)
  • Always check TSH, electrolytes, and that party animal history (👀 looking at you, E for Ethanol).

If your patient’s heart is behaving like a pirate mutiny — irregular, chaotic, and slightly drunk — remember: PIRATES did it. Blame the booze, the lungs, the thyroid, or just good ol’ atrial rebellion.

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HAPPY LEARNING, folks! 🙂

Signing off,

Dr. Aurangzaib Qambrani
(MBBS, PLAB, MRCP-UK 1)
Sheikh Khalifa Bin Zayed Hospital Quetta






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