Atrial Fibrillation Flashcards Preview

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Flashcards in Atrial Fibrillation Deck (14):
1

Atrial fibrillation

Arrhythmia characterised by an irregularly irregular rhythm, which is a result of is characterised by uncoordinated atrial activity on the surface ECG, with fibrillatory waves of varying shapes, amplitudes, and timing associated with an irregularly irregular ventricular response when atrioventricular (AV) conduction is intac

2

Different classifications of Atrial Fibrillation (5)

Paroxysmal AF lasts <7 days

Persistent AF lasts >7 days

Long Standing Persistent AF lasts >1 year in duration

Permanent Atrial Fibrillation refractory to cardioversion and sinus rhythm cannot be restored or maintained

Non-Valvular Atrial Fibrillation absence of rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair.

3

Common causes for paroxysmal AF (3)

Infection
Exacerbation of Heart failure
Post MI
Thyrotoxicosis

4

Risk factors for AF

Age
Diabetes
HTN
CHF
CAD
Hyperthyroidism
Other atrial arrhythmia

5

Signs and symptoms of newly onset AF

Risk factors
Irregularly irregular
Hypotension
Elevated JVP
Added heart sound

6

Treatment for Haemodynamically unstable AF

Direct current conversion

7

Treatment for Haemodynamically stable AF with left atrial thrombus

No heart failure:
B Blocker and or CCB (rate control)
Anti-coagulation
Cardioversion

Heart failure:
Digoxin or Amiodarone (rate control)
Anti-coagulation
Cardioversion

8

Treatment for Haemodynamically stable AF without left atrial thrombus

No heart failure CHA2DS2-VASc 0-1:
B Blocker and or CCB (rate control)
Cardioversion

No heart failure CHA2DS2-VASc >2:
B Blocker and or CCB (rate control)
Cardioversion + Heparin

Heart failure:
Digoxin or Amiodarone (rate control)
Anti-coagulation
Cardioversion + Heparin

9

Cardioversion drugs (5)

Flecainide
Propafenone
Amiodarone
Dronedarone
Ibutilide
Sotalol

10

Causes of chronic AF (6)

All types of cardiac disease
Thyroid disease
Autonomic neuronal dysfunction
Alcohol and caffeine abuse
Non-cardiac pulmonary hypertension
Infections.

11

Strong risk factors for chronic AF (5)

hypertension
coronary artery disease
congestive heart failure
advancing age
diabetes mellitus
rheumatic valvular disease
alcohol abuse
male sex
presence of other arrhythmias
smoking

12

CHA2DS2-VASc

Congestive heart failure 1
Hypertension 1
Age ≥ 75 2
Age 65-74 1
Diabetes mellitus 1
Stroke/TIA/thrombo-embolism 2
Vascular disease 1
Sex Female 1

13

What is CHA2DS2-VASc?

Calculation for risk of stroke in AF patients

14

What is the recommendation for anti-coagulation based on the score?

0 = “low” risk. Doesn't require anti-coagulation
1 = “low-moderate” risk. Consider anti-platelet or anti-coagulation
>2= “moderate-high” risk. Anticoagulation candidate.
(Remember for females, they automatically get 1 for being female so 1 is low risk)