Atrial Fibrillation

Question 1

What is the purpose of the CHA2DS2VaS score?

Answer 1

Determine the risk of stroke and therefore need for anticoagulation in patients for AF

C - Congestive heart failure - +1
H - Hypertension - +1
A2 - Age 65-74 +1, Age 75+ - +2
D - diabetes
S2 - Stroke, TIA, VTE history
Vas - Vascular disease +1
S - Sex female +1 (if only score 1 for female, dont offer anticoagulation. If male and scores 1, offer)

0 = no anticoagulation
1 = consider anticoagulation if a man
2 or more = offer anticoagulation

Question 2

What is the management of AF?

Answer 2

Haemodynamically unstable? -> ABCDE -> DC cardioversion

Haemodynamically stable and onset < 48hours? -> rate/rhythm control -> consider anticoagulation using CHA2DS2VaS score

Haemodynamically stable and onset > 48h -> rate control and anticoagulation (anticoagulate if delayed rhythm control is decided) after 4 weeks give DC cardioversion -> consider anticoagulation using CHA2DS2VaS score