AF Flashcards
what does incidence inc with
age
what is paroxysmal
lasting less than 48 hours
what is persistent
> 48 hr which can still eb cardioverted to NSR
what is permanent
inability of pharmacological methods to restore
lone AF (idiopathic)
absence of any heart disease and no evidence of ventricular dysfunction
significant stroke rate
when are symptoms often worse
onset
what is the mechanisms
multiple wavelets of reentry
ectopic focus around the pulmonary veins
termination
drugs, electrical cardioversion or spontaneously
ECG
no p waves, f waves
irregularly irregular
how does it affect CO
lose atrial kick and dec filling times (dec diastole) - dec CO
can result in congestive heart failure
rate control options
digoxin, BB and Ca channel blockers
alone or in combination
rhythm contro - restore NSR
pharmacological cardioversion (amiodarone or fleicanide)
or DCCV
when is fleicanide preferred
no structural abnormalities
maintenance of rhythm control
anti arrhythmic drugs, catheter ablation of ectopic focus or surgery
what surgery
maze procedure
what is the aim of electrical cardioversion
immediate restoration of sinus rhythm
name class I A
disopyramide
name class IB
lidocaine
name class IC
fleicanide
what do class I drugs do
prevent Na influx
what do class 2 drugs do
prevent Ca influx - dec rate of depolarisation in SAN and AVN
what do class 3 drugs do
prevent K efflux - prolong AP duration
as does hypokalaemia
torsades de pointes ecg features
long QT, wide and changing QRS
TdP mechanism
hypokalaemia, prolonged AP duration, long QT syndrome or renal impairment resulting in inc drug levels
class III drugs
amiodarone, sotalol and dronedarone
what is valvular AF
patients with mitral valve disease or prosthetic valve
what is the CHA2DS2-VASc for
determine the need for anticoagulation if patient has AF
what is the HAS-BLED for
risk of major bleeding for patients on anticoagulation for atrial fibrillation.
what does radiofrequency ablation of AF focus do
maintain SR
- usually in pulmonary veins
what does radiofrequency ablation of the AVN do
stop fast conduction of the ventricles
where is the atrial flutter circuit confined to
RA
what does atrial flutter usually progress to
atrial fibrillation
what may atrial flutter result in
thromboembolism
what is the atrial flutter mechanism
macro reentrant circuit
what are the atrial flutter treatment options
RF ablation
pharmacological therapy
cardioversion
warfarin to prevent thrombembolism
