Cardiovascular Disease-Atrial Fibrillation

Question 1

Atherosclerosis

Answer 1

A condition that develops when plague builds up in the walls of the arteries; causes to stop blood flow
*causes a heart attack or stroke (leading cause of death)

Question 2

Heart Attack

Answer 2

blood clot stops blood flow to a part of the heart and therefore cardiac muscle cells die

Question 3

Ischemic Stroke

Answer 3

the most common, when the blood vessel to brain gets blocked and brain cells die

Question 4

Hemorrhagic Stroke

Answer 4

when the blood vessel within brain burst

Question 5

Congestive Heart Failure

Answer 5

heart is not pumping blood as well as it should be

Question 6

Arrhythmia

Answer 6

Abnormal rhythm of the heart

Question 7

Heart valve problems

Answer 7

stenosis, regurgitation, mitral valve prolapse

Question 8

Atrial Fibrillation

Answer 8

-upper heart chambers contract irregularly
-Most common cardiac arrhythmias
-2.7 million Americans have it
Quivering or irregular heartbeat
Multiple reentrant circuits in the atria

Question 9

Ventricular Fibrillation

Answer 9

Disorganized contraction of the lower chambers of the heart

Question 10

Bradycardia

Answer 10

Slow heart rate

Question 11

Tachycardia

Answer 11

Very fast heart rate

Question 12

Conduction Disorders

Answer 12

Heart does not beat normally

Question 13

Premature contraction

Answer 13

early heart beat

Question 14

ECG of A fib

Answer 14

missing P wave which is the absence of atrial depolarization
SA node may not start the contraction
-electrical current does not flow because the contractions are so rapid and disorganized
-AV node often cant regulate the chaotic current (vetnricles beat more often)

Question 15

ECG of slow ventricular response

Answer 15

spacey small peaks

Question 16

Moderate ventricular response

Answer 16

larger negative peaks

Question 17

Rapid Ventricular Response

Answer 17

multiple large positive peaks

Question 18

Conversion back to normal sinus rhythm

Answer 18

electrical cadioversion
radiofrequency ablation
maze procedure

Question 19

electrical cardioversion

Answer 19

low voltage electric current to reset heart rhythm to normal sinus rhythm
pacemaker

Question 20

radiofrequency ablation

Answer 20

use radio waves to manage arrhythmias, usually before pacemaker

Question 21

maze operation

Answer 21

create scar tissue to block abnormal signal, direct electric signal through a controlled path to ventricle

Question 22

Controlling ventricular rate response

Answer 22

Reducing overly high heart rate 
Medicines:
digoxin
beta blockers
calcium channel blockers
anti-arrhythmic

Question 23

Digoxin

Answer 23

slow HR, at atria to ventricle through inhibition of sodium potassium adenosine triphosphatase

Question 24

Beta-Blockers

Answer 24

slow HR

Antagonists that block the receptor sites for EPI and NE on adrenergic beta receptors of SNS

Question 25

Calcium-Channel blockers

Answer 25

slow HR, reduce strength of cardiac muscle contraction | prevent or reduce the calcium channels

Question 26

Preventing blood clots

Answer 26

antiplatelets anticoagulants antithrombotic

Question 27

Exercise response on atrial fib

Answer 27

Rapid irregular ventricular heart rate - HR is high at any workload - reduced SV due to limited atrial assistance during diastole - HR response can be affected by comorbid conditions and medications * exercise capactiy is reduced by 15-20%

Question 28

Exercise Testing considerations

Answer 28

- Age predicted heart rate max is not valid - irregular ventricular response may make BP determination less precise or more difficult - Beta-Blockers may reduce exercise capacity, decrease submaximal HR and BP - Verapamil (Calcium Channel Blockers) may mask ischemia and decrease HR response to exercise - Digoxin may control ventricular response; diffuse ST effects

Question 29

Exercise Programming

Answer 29

because ventricular rate is so irregular... work rate or perceived exertion should be prescribed Comorbidities are important to ascertain in population with AF Must watch for HYPOTENSION

Question 30

Short term effects of exercise on AF

Answer 30

reduced AF burden | reduced symptom severity

Question 31

Long term effects of exercise on AF

Answer 31

increase AF freedom | reduced symptom severity

Question 32

Potential Mechanisms of exercise on AF

Answer 32

``` Reversed atrial remodeling Weight loss Improved BP Improved glycemic control Reduced Inflammation Improved autonomic tone ```