Atrial fibrillation Flashcards
1
Q
What is the definition of AF?
A
Irregularly irregular fast heart beat
2
Q
What is the epidemiology of AF?
A
Common. Occurring in 1-2% of the general population
3
Q
What is the pathology of AF?
A
- Rapidly firing ectopic foci located inside 1 or more pulmonary veins
- Abnormal atrial tissue substrate - ↑ atrial pressure, ↑ atrial muscle mass, atrial fibrosis, inflammation and infiltration of the atrium
- Only a proportion of electrical impulses in the atria reach the ventricles
4
Q
What are the risk factors/aetiology of AF?
A
- Hypertension
- Heart failure
- Rheumatic heart disease
- Cardiac conditions/ Valve disease: Sinus sick syndrome, Wolff-Parkinson-White syndrome, heart failure
- Alcohol intoxication
- Thyrotoxicosis
- Hyperthyroidism
- Caffeine
- Smoking
- Cardiac surgery
- Idiopathic
- Genetics/family history
5
Q
What are the signs/symptoms of AF?
A
- Palpitations
- Fatigue
- SOB
- Chest pain
- ↓ exercise capacity
- Dizziness/syncope
- Irregularly irregular pulse – maintained during exercise
- Ventricular rate usually 120-180 beats per minute
6
Q
What other diseases does AF present similarly to?
A
- Atrial flutter
- Atrial extrasystoles
- Supraventricular tachyarrhythmias
- Atrioventicular nodal re-entrant tachycardia
- Wolff-Parkinson-White syndrome
- Ventricular tachycardia
7
Q
What investigations are conducted if AF is suspected?
A
- ECG – fibrillation and no clear p waves, QRS rhythm is rapid and irregular
- FBC
- U&E
- TFTs
- CXR
- Transthoracic echocardiography
8
Q
What are the surgical treatments for AF?
A
• Cardioversion – electrical DC shock/IV drugs
9
Q
What are the pharmacological treatments for AF?
A
- Antiarrhythmic drug – Quinidine, Beta blockers, amiodarone
- Rate controlling drugs – digoxin, beta blockers, Ca channel blockers
- Oral anticoagulant e.g. warfarin, NOACs – need to be calculated by the CHA2DS2-VASc scoring system
10
Q
What are the non pharmacological treatments for AF?
A
• Avoid alcohol/caffeine if possible
