Cardio AF Flashcards
(46 cards)
what type of arrhythmia is AF
supraventricular
what is the typical ventricular rate of AF
180
what are the three types of af
paroxysmal
persistent
permanent
what is paroxysmal af
episodes lasting longer than 30 seconds but less than 7 days (often less than 48 hours) that are self-terminating and recurrent
what is persistent af
episodes lasting longer than 7 days (spontaneous termination of the arrhythmia is unlikely to occur after this time) or less than seven days but requiring pharmacological or electrical cardioversion
what is permanent AF
AF that fails to terminate using cardioversion, AF that is terminated but relapses within 24 hours, or longstanding AF (usually longer than 1 year) in which cardioversion has not been indicated or attempted (sometimes called accepted permanent AF)`
what are the three most common associations with AF
hypertension
coronary artery disase
MI
what are the main complications of AF
stroke
thromboembolism
heart failure due to ineffective ventricular filling
what reduces the risk of stroke in af by 2/3rds
anticoagulation
what non cardiac conditions raise suspicion of AF
diabetes
thyroid disease
cancer
alcohol misuse
if someone has palpitations chest discomfort and breathlessness which are episodic and last less than 48 hours what should you suspect
paroxysmal af
how do you diagnose AF
ECG
what is seen on an ecg of af
no p wave s
irregular
ventricular rate of 180
what do you do if paroxysmal AF is suspected and AF is not detected on ECG
24 hour ECG monitor if less than 24 hrs between symptoms
If more than 24 hours between symptoms use either an event recorder or a 7 day holter monitor
what is the differential diagnosis of an irregular pulse
af atrial flutter atrial extrasystole ventricular ectopics sinus tachy svt
what are the main reported symtpoms of AF
breathlessness s
chest discomfort
palpitations
irregular heart beat
If the onset of atrial fibrillation (AF) was within the last 48 hours and is showing signs of haemodynamic instability: how do you manage them?
urgent admission for cardioversion
what is classed as haemodynamic instability
rapid pulse (greater than 150 beats per minute) and/or low blood pressure (systolic blood pressure less than 90 mmHg), loss of consciousness, severe dizziness or syncope, ongoing chest pain, or increasing breathlessness
If the onset of atrial fibrillation (AF) was within the last 48 hours and is NOT showing signs of haemodynamic instability: how do you manage them?
either cardioversion or management in primary care dependent on clinical judgment and patient preference
for all people with diagnosed AF what should you do
rule out cardiac and non cardiac underlying causes so arrange echo
AF with lung cause suspected arrange
CXR
if systemic cause suspected arrange
FBC TFTS UE electrolyte calcium magnesium and glucose measurements
what to do to reduce AF episodes
weight loss treat underlying cause such as diabetes hypertension and sleep apnoea
when to refer to a cardiologist
WPW valvular disease suspected HF
