AF

Question 1

Causes of AF

Answer 1

IHD
Rheumatic heart disease
Thyrotoxicosis
HTN

Question 2

Sx of AF?

Answer 2

Asymptomatic but also

• chest pain/ palpitations
• SOB
• Fainting

Question 3

Sign of AF?

Answer 3

• Irregularly irregular pulse

- signs of LVF

Question 4

4 types of AF?

Answer 4

Acute (<48hrs)
Paroxysmal ( <7 days, may recur)
Persistant (>7d)
Permanent (> 1yr)

Question 5

Acute AF mx?

Answer 5

Emergency cardioversion
Control ventricular rate
Start LMWH

Question 6

Control of ventricular rate meds 1st line?

Answer 6

diltiazem or verapamil or metoprolol

Question 7

Control of ventricular rate meds 2nd line?

Answer 7

digoxin or amiodarone

Question 8

Paroxysmal AF mx?

Answer 8

• Anticoagulate (chadsvasc)

- PNR: flecainide, propafenone

Question 9

Prevention of AF

Answer 9

B blocker or
Sotalol or
Amiodarone

Question 10

Antiarrhythmics for persistent AF

Answer 10

• Not needed if successfully treated precipitant
• 1st line: beta blockers
• 2nd line: amiodarone

Question 11

Rate for rate control aim for persistent AF?

Answer 11

<90 bpm at rest

Question 12

Rate control for persistent AF?

Answer 12

1st: b-blocker or CCB (not both)
2nd: add digoxin
3rd: consider amiodarone

Question 13

Mx of permanent AF?

Answer 13

Rate control

Question 14

Mx of persistent AF?

Answer 14

Rate control + antiarrhythmics

Question 15

CHADSVAS score use?

Answer 15

if anticoagulation necessary in AF

Question 16

Chadsvas component?

Answer 16

CHA2DS2 VAS

• CCF
• HTN
• Age≥75 (2 points)
• DM
• Stroke or TIA (2 points)
• Vascular disease
• Age: 65-74yrs
• Sex: female

Question 17

CHA2DS2VAS interpretation

Answer 17

0 aspirin 300 mg

1 or more: anticoagulant