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Atrial Fibrillation Daily Monitoring Log

Track Your Heart Rhythm, Symptoms, and Medications

Cardiology

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Template Content

Last updated: Mar 24, 2025

Patient Information

Name: ___________________ Date Started: ___________________ Physician: _______________ Contact: _______________________

Daily Tracking Sheet

Vital Signs

Date Time Heart Rate Blood Pressure Symptoms*

*Symptom Key:

  • D = Dizziness
  • P = Palpitations
  • F = Fatigue
  • SOB = Shortness of breath
  • C = Chest discomfort

Medication Log

Medication Dosage Time Taken Missed? (Y/N)

Additional Notes

Record any triggers, lifestyle factors, or concerns:

Emergency Warning Signs

Seek immediate medical attention if you experience:

  • Severe chest pain
  • Fainting or severe dizziness
  • Inability to breathe
  • Sustained rapid heartbeat

Follow-up Appointments

Next appointment: ________________ INR check (if applicable): ________

Bring this log to all medical appointments

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