Atrial fibrillation Flashcards
what is dominant pacemaker of the heart?
SA node
how does a fib occur?
SA node fails or is no longer in control
how can arrhythmia formation occur?
- abnormal impulse formation
- abnormal impulse conduction
what is the normal heart beat range?
60-100bpm
what is characteristic of a fib pulse
irregular rate and irregular rhythm
what is the screening standard for a fib?
oppertunistic screening when above 65 years old
what are the different patterns of A fib
paroxysmal AF - continuous AF episode that lasts longer than 30 seconds but less than 7 days
persistent AF - continuous AF episode that lasts longer than 7 days and less than 1 year
longstanding persistent AF - lasts less than a year and we are pursuing rhythm control
permanent AF - more than 1 year and chosen not to pursue rhythm control
Valvular AF - AF in presence of a mechanical valve or in the presence of mod to severe mitral stenosis
what are some risk factors for A fib?
- sleep apnea
- DM
- high BP
- Alcohol and tobacco
signs and symptoms
palpitations, SOB, dyspnea, fatigue, exercise intolerance, lightheadedness, chest pain
complications of A fib
angina, HF, Stroke
explain how a stroke occurs in a fib
blood pools in atria and clot forms which then travels up to the brain where it occludes a vessel
if a patient presents to ER and is hemodynamically unstable (what constitutes unstable) what do we do
hemodynamically unstable - ACS, hypotension, pulmonary edema
urgent DCCV ( direct current cardioversion)
if hemodynamically stable what are the two treament barcnhes
rate and rhythm
when is rhythm preferred, and when is rate preferred?
rhythm
- new diagnosis
- less then 65
- high symptom burden
rate
- over 65
- failed rhthm
what is algorithm for rate control
if LVEF .40%Beta-blockers or CCB
if inadqeaunt contorl
