AF

Question 1

what does incidence inc with

Answer 1

age

Question 2

what is paroxysmal

Answer 2

lasting less than 48 hours

Question 3

what is persistent

Answer 3

> 48 hr which can still eb cardioverted to NSR

Question 4

what is permanent

Answer 4

inability of pharmacological methods to restore

Question 5

lone AF (idiopathic)

Answer 5

absence of any heart disease and no evidence of ventricular dysfunction

significant stroke rate

Question 6

when are symptoms often worse

Answer 6

onset

Question 7

what is the mechanisms

Answer 7

multiple wavelets of reentry

ectopic focus around the pulmonary veins

Question 8

termination

Answer 8

drugs, electrical cardioversion or spontaneously

Question 9

ECG

Answer 9

no p waves, f waves

irregularly irregular

Question 10

how does it affect CO

Answer 10

lose atrial kick and dec filling times (dec diastole) - dec CO

can result in congestive heart failure

Question 11

rate control options

Answer 11

digoxin, BB and Ca channel blockers

alone or in combination

Question 12

rhythm contro - restore NSR

Answer 12

pharmacological cardioversion (amiodarone or fleicanide)

or DCCV

Question 13

when is fleicanide preferred

Answer 13

no structural abnormalities

Question 14

maintenance of rhythm control

Answer 14

anti arrhythmic drugs, catheter ablation of ectopic focus or surgery

Question 15

what surgery

Answer 15

maze procedure

Question 16

what is the aim of electrical cardioversion

Answer 16

immediate restoration of sinus rhythm

Question 17

name class I A

Answer 17

disopyramide

Question 18

name class IB

Answer 18

lidocaine

Question 19

name class IC

Answer 19

fleicanide

Question 20

what do class I drugs do

Answer 20

prevent Na influx

Question 21

what do class 2 drugs do

Answer 21

prevent Ca influx - dec rate of depolarisation in SAN and AVN

Question 22

what do class 3 drugs do

Answer 22

prevent K efflux - prolong AP duration

as does hypokalaemia

Question 23

torsades de pointes ecg features

Answer 23

long QT, wide and changing QRS

Question 24

TdP mechanism

Answer 24

hypokalaemia, prolonged AP duration, long QT syndrome or renal impairment resulting in inc drug levels

Question 25

class III drugs

Answer 25

amiodarone, sotalol and dronedarone

Question 26

what is valvular AF

Answer 26

patients with mitral valve disease or prosthetic valve

Question 27

what is the CHA2DS2-VASc for

Answer 27

determine the need for anticoagulation if patient has AF

Question 28

what is the HAS-BLED for

Answer 28

risk of major bleeding for patients on anticoagulation for atrial fibrillation.

Question 29

what does radiofrequency ablation of AF focus do

Answer 29

maintain SR - usually in pulmonary veins

Question 30

what does radiofrequency ablation of the AVN do

Answer 30

stop fast conduction of the ventricles

Question 31

where is the atrial flutter circuit confined to

Answer 31

RA

Question 32

what does atrial flutter usually progress to

Answer 32

atrial fibrillation

Question 33

what may atrial flutter result in

Answer 33

thromboembolism

Question 34

what is the atrial flutter mechanism

Answer 34

macro reentrant circuit

Question 35

what are the atrial flutter treatment options

Answer 35

RF ablation pharmacological therapy cardioversion warfarin to prevent thrombembolism