Atrial arrhythmias

Question 1

what are the 4 classifications of AF

Answer 1

first detected // paroxysmal // persistant // perminant

Question 2

what is persistent AF

Answer 2

not self terminating and usually last 7+ days

Question 3

presentation a fib

Answer 3

palpitations, dyspnoea, chest pain, irregularly, irregular pulse

Question 4

how should a haemodynamically unstable AF patient be treated

Answer 4

shocks per ALS

Question 5

how should AF within 48 hours of presentation be treated (broadly)

Answer 5

1)rhythm control 2) rate

Question 6

how should AF presenting >48hours or uncertain timing be treated (broadly)

Answer 6

rate conrol

Question 7

how long should late presenting AF patients be treated with anticoags before they are cardioverted

Answer 7

3 weeks

Question 8

when would rate control not be 1st line in AF (4)

Answer 8

reversible cause // HF caused by AF // new onset (<48hrs) // Atrial flutter

Question 9

rate control meds AF (3)

Answer 9

BB // CCB // digoxin

Question 10

when are BB contraindicated

Answer 10

asthma

Question 11

what rhythm control drugs for longterm AF (3)

Answer 11

BB // dronedarone // amiodarone (esp with HF)

Question 12

when is catheter ablation for AF indicated

Answer 12

patients who have not responded to meds

Question 13

what medication should be given for 4 weeks prior to AF catheter ablation

Answer 13

anticoags

Question 14

complications of cathether ablation

Answer 14

tamponade // stroke // pulm vein stenosis

Question 15

when may shocks be given in AF

Answer 15

haemodynamically unstable

Question 16

what part of an. ECG is electrical cardioversion delivered to in AF

Answer 16

R wave

Question 17

what drug should patients recieve prior to electrical cardioversion in AF if defo onset <48 hours

Answer 17

heparin

Question 18

what drug can be used for cardioversion in AF

Answer 18

amiodarone or flecainide

Question 19

in patients with onset >48hrs of AF what type of cardiversion is recommended

Answer 19

electrical

Question 20

how long should patients with AF onset >48 hours be anticoagulated before and after electrical cardioversion

Answer 20

3 weeks before and at least 4 after

Question 21

what score is used to determine risk of stroke/ need for anticoag in AF

Answer 21

CHA2DS2VASC

Question 22

what are the RF in the scoring for anticoag in AF (7)

Answer 22

congestive HF // hypertension // age // diabetes // stroke prior // bascular disease // sex (female)

Question 23

what scores for anticoag post AF would warrant treatment

Answer 23

0= none // 1 = coag for males // 2 = coag for males and females

Question 24

if there is no indication for anticoag post AF what test must be done

Answer 24

echo to exclude valvular disease

Question 25

what score is used to assess a patients risk of bleeding if started on anticoags post AF

Answer 25

ORBIT score

Question 26

what components make up ORBIT (5)

Answer 26

ANEAMIE // RENAL IMPAIRMENT // age, platelet treatment, bleeding history

Question 27

if anticoag treatment is indicated post AF what is 1st and 2nd line

Answer 27

1st = DOAC // 2nd = warfarin

Question 28

if AF causes a TIA when should anticoag be started

Answer 28

immediately (DOAC)

Question 29

if AF causes a stroke when should anticoag be started

Answer 29

antiplatelets 2 weeks –> anticoag

Question 30

what needs to be ruled out before starting stroke/ TIA patients on anticoag

Answer 30

haemorrhage

Question 31

what type of arrhythmia is atrial flutter

Answer 31

SVT

Question 32

what ECG findings in atrial flutter

Answer 32

sawtooth // 150bpm

Question 33

mx for atrial flutter

Answer 33

similar to AF - more sensitive to cardioversion