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Introduction: Atrial fibrillation(AF) is the rapid and irregular beating of the atrial muscles that bypasses the natural heart rate and rhythm. This abnormal twitching of the atrium may increase heart rate and cause a drop in stroke volume leading to symptoms of heart failure. Irregular flow of blood also causes blood stasis in atria, leading to clot formation and subsequent emboli development. This review will discuss in brief various diagnostic and management modalities of atrial fibrillation. Aim of Work: The aim of this study is to discuss the diagnosis and management of atrial fibrillation Materials and methods: This review is a comprehensive search of PUBMED from the year 2003 to 2021. Conclusion: This review briefly discusses atrial fibrillation, its diagnosis, and treatment modalities. In atrial fibrillation, asynchronous and abnormal contractions of atrial cardiac muscles lead to abnormal rate and rhythm of heartbeats. This often leads to symptoms of heart failure and episodes of stroke. Factors that predispose to AF are cardiac diseases, diabetes, smoking, and excessive alcohol consumption. Diagnosis of AF requires a thorough history and physical examinations, laboratory evaluations, electrocardiogram, and certain imaging such as MRI and CT. Various treatment modalities are cardioversion, antiarrhythmic drugs, cardiac ablation therapy, and certain surgical procedures like maze surgery & left atrial appendage obliteration Keywords: Atrial fibrillation, arrhythmia, electrocardiogram, cardioversion, cardiac ablation.

Background: Microsurgical aneurysm (MSA) clipping is considered as the standard therapy with the endovascular coiling. Microsurgical clipping is considered superior to endovascular in terms of the recurrence rate. The management of recurrent aneurysm following previous microsurgical clipping is challenging. The management of recurrent aneurysm following previous microsurgical clipping is challenging. This study aims to explore the management of recurrent aneurysm of the anterior communicating artery (ACoM). Materials and Methods: This is a case series of three elder women who had a recurrence of ACoM aneurysm after MSA clipping. All the three patients were operated with microsurgical clipping. We studied the preoperative images of the first surgery of all the patients. The detailed case-by-case analysis was performed based on preoperative, postoperative, and follow-up radiologic examinations and operative findings. Results: All three patients who had a recurrence after MSA clipping of ACoM aneurysm and were asymptomatic. At presentation, they were diagnosed at the postoperative imaging at follow-up. The earliest recurrence was 1 year while in one patient; the recurrence was detected 8 years after the initial MSA clipping. The cerebral aneurysms were posteriorly directed in the initial preoperative images in all the cases. Conclusion: This study revealed the recurrence as the residual neck or the enlargement of the aneurysm even after MSA in these cases of ACoM aneurysm. Even with the complete clipping, there can be recurrence at the clip site due to the change in hemodynamics over the time. We should follow-up the patients regularly even after microsurgical clipping.

Extracranial internal carotid artery aneurysms (EICA) are rare. Incidence is