atrial fibrilation

Question 1

What is an arrhythmia

Answer 1

an abnormality in cardiac rhythm

Question 2

what is atrial fibrillation

Answer 2

where the contraction of the atria is uncoordinated, rapid and irregular

Question 3

why does AF occur

Answer 3

disorganised electrical activity that overrides the normal, organised activity from the sinoatrial node

Question 4

What would an ecg show for AF

Answer 4

Absent P waves
irregular and rapid narrow QRS complex

Question 5

presenting symptoms of AF could be …?

Answer 5

Palpitations
Shortness of breath
Syncope (dizziness or fainting)
Symptoms of associated conditions (e.g. stroke, sepsis or thyrotoxicosis

Question 6

two differential diagnoses for an irregularly irregular pulse

Answer 6

-Atrial fibrilation
-ventricular ectopics

Question 7

how would you differentiate AF and ventricular ectopic

Answer 7

ventricular ectopic disappear when the heart rate gets overa certain threshold

Question 8

what is tachycardia

Answer 8

HR above 100beats per minute

Question 9

two types of af and the difference

Answer 9

Valvular af = AF + mitral stenosis
Non - valvular = AF + without/ other valve pathology

Question 10

two methods of treating AF

Answer 10

RATE CONTROL OR RHYTHM CONTROL
ANTI COAGULANTS

Question 11

describe the acute management for AFib

Answer 11

• DC cardioversion or FLECANIDE /AMIODARONE if unsuccesful
• if >48hrs then give anticoagulation for three weeks before cardioversion or rate control , BB or CCB.

Question 12

chronic management of Afib

Answer 12

rate control BB , rate limiting calcium channel blocker and if it fails add digoxin and then consider amiodarone
- if rhythm control is chosen make sure to give anticoagulation for a month

Question 13

what is paroxsymal atrial fibrilation

Answer 13

when AF comes and goes in episodes

Question 14

what are the two shockable rhymths

Answer 14

ventricualr tachycardia
ventricular fibrilation

Question 15

two non shockable rhythms

Answer 15

pulseless electrical activity
asystole

Question 16

What can cause atrial fibrilation

Answer 16

• mitral stenosis - fibrosis
• HF
  -Sarcoidosis

Question 17

what would deem a patient unstable

Answer 17

shock
hf
syncope
myocardial ischaemia

Question 18

management for unstable patients

Answer 18

Emergency cardioversion

Question 19

classification of afib

Answer 19

• first detected episode
• paroxsymal af
• persistent af
• permanent af

Question 20

what can you do for rate control

Answer 20

beta blocker or rate limiting calcium channel blocker to control the rate

Question 21

Rate control should be offered as the first‑line treatment strategy for atrial fibrillation except in people:

Answer 21

-atrial fibrillation has a reversible cause -heart failure thought to be primarily caused by atrial fibrillation
-with new‑onset atrial fibrillation (< 48 hours)
-with atrial flutter whose condition is considered suitable for an ablation strategy to restore sinus rhythm
f-or whom a rhythm‑control strategy would be more suitable based on clinical judgement

Question 22

notable complications of afib

Answer 22

cardiac tamponade
stroke
pulmonary vein stenosis