Flashcards in Atrial Fibrillation Deck (21):
Why does AF cause an irregular rhythm?
Chaotic atrial signalling causes atrial ‘spasming’. This causes an irregular rhythm due to irregular stimulation of AVN.
What does an ECG show with a patient in AF?
Irregularly irregular waves and no p waves
What is paroxysmal AF?
Term used If episodes of AF terminate spontaneously. Usually last less than 7 days.
What is persistent AF?
Arrhythmia is not self-terminating. Usually last longer than 7 days.
How is permanent AF managed?
Rate control and anti-coagulation
What are symptoms of AF?
palpitations, chest pain, dyspnoea
What are the signs of AF?
irregularly irregular pulse
How is AF managed?
Rate or rhythm control
What is the predominant management approach?
What are first-line drugs are used for rate control?
beta-blocker or a rate-limiting calcium channel blocker (e.g. diltiazem)
What is second line rate control treatment?
combination therapy with any 2 of the following:
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.
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.
What is stroke risk scoring system used in AF?
What can be used to anti-coagulate?
Warfarin or DOACs
What risk scoring is used for starting someone on warfarin?
What score is considered a high-risk of bleeding?
Which 3 medications can be used for rhythm control?
Solatol, amiodarone or fleicanide
Which factors favour a rate control approach?
- older than 65 y/o
- history of ischaemic heart disease
Which factors favour a rhythm control approach?
- younger than 65 y/o
- first presentation
- lone AF or secondary to corrected precipitant
- congestive HF