Atrial Fibrillation Flashcards
what are the common causes of AF
S - sepsis
M - mitral valve pathology
I - ischaemic heart disease
T - thyrotoxicosis
H - hypertension
what are the three types of AF
paroxysmal: starts and stops on its own
persistent: wont stop unless treated
permanent: preferred rhythm of the heart, may not need or respond to treatment
what are predisposing factors to AF
anything which leads to LA dilatation or dilatational cardiomyopathy
- HTN, IHD, mitral valve disease, alcohol
what are some precipitation factors for AF
sepsis
thyrotoxicosis
surgery
hypokalaemia
MI
caffeine
stimulants
alcohol binging
what is used for anticoagulation in AF
DOACs - rivaroxaban, apixiban
if cant have DOAC then warfarin
outline the points for CHADSVAS
C - CHF
H - hypertension
A - >75 (+2)
D - diabetes
S - previous stroke (+2)
V - vascular disease
A - aged 65-74
S - female sex
what scores can be used to assess risk of bleeding in anticoagulated AF patients
HASBLED
ORBIT
rate control is first line in those with AF except:
reversible cause of AF
new onset <48 hours
HF caused by AF
symptoms despite rate control
what are the options for rate control in AF patients
beta blockers
CCB
digoxin: requires monitoring and only effective in those who are sedentary
when would you offer immediate cardioversion in AF
symptoms <48 hours
AF causes life threatening haemodynamic instability
what medical options are there for rhythm control in AF
Flecanide
Amiodarone - safe in those with structural heart disease
long term can use BB or amiodarone
how is paroxysmal AF managed
‘pill in pocket’
flecainide taken when they experience symptoms
