Atrial Fibrillation Flashcards Preview

Case 1 Chest Pain > Atrial Fibrillation > Flashcards

Flashcards in Atrial Fibrillation Deck (21):
1

Why does AF cause an irregular rhythm?

Chaotic atrial signalling causes atrial ‘spasming’. This causes an irregular rhythm due to irregular stimulation of AVN.

2

What does an ECG show with a patient in AF?

Irregularly irregular waves and no p waves

3

What is paroxysmal AF?

Term used If episodes of AF terminate spontaneously. Usually last less than 7 days.

4

What is persistent AF?

Arrhythmia is not self-terminating. Usually last longer than 7 days.

5

How is permanent AF managed?

Rate control and anti-coagulation

6

What are symptoms of AF?

palpitations, chest pain, dyspnoea

7

What are the signs of AF?

irregularly irregular pulse

8

How is AF managed?

Rate or rhythm control

9

What is the predominant management approach?

Rate control

10

What are first-line drugs are used for rate control?

beta-blocker or a rate-limiting calcium channel blocker (e.g. diltiazem)

11

What is second line rate control treatment?

combination therapy with any 2 of the following:
a betablocker
diltiazem
digoxin

12

When should rhythm control be considered first?

In a patient with coexistent heart failure, first onset AF or where there is an obvious reversible cause.

13

What are the criteria for cardioversion? (2)

a short duration of symptoms (less than 48 hours) or

be anticoagulated for a period of time prior to attempting cardioversion.

14

What is stroke risk scoring system used in AF?

CHA2DS2VASc

15

What can be used to anti-coagulate?

Warfarin or DOACs

16

What risk scoring is used for starting someone on warfarin?

HAS-BLED

17

What score is considered a high-risk of bleeding?

3

18

Which 3 medications can be used for rhythm control?

Solatol, amiodarone or fleicanide

19

Which factors favour a rate control approach?

- older than 65 y/o
- history of ischaemic heart disease

20

Which factors favour a rhythm control approach?

- younger than 65 y/o
- symptomatic
- first presentation
- lone AF or secondary to corrected precipitant
- congestive HF

21

Which 2 medications can be used to pharmacologically cardiovert?

amiodarone

or

fleicanide (if no structural heart disease)