afrial fibrillation Flashcards
what is AF
Uncoordinated, rapid and irregular contraction of the atria due to disorganised electrical activity which overrides the normal activity from the SAN.
AF on ecg
Absence of P waves
Narrow QRS complex tachycardia
Irregularly irregular ventricular rhythm
loss of a wave on JVP form so single wave
rise in JVP durin inspiration known as kussumal sing is pathological of what
constrictive pericarditis
cannon a waves sign of what
compelte heart blcok
large a waves sign of what
pulmoary hypetension or stenosis
large v waves
triscupid regurgitation
MRS smith cuases
Sepsis
Mitral valve pathology
Ischaemic heart disease
Thyrotoxicosis
HTN
sx
Palpitations
SoB
Syncope
Symptoms of associated conditions (e.g. stroke, sepsis or thyrotoxicosis)
tx should involve Assess haemodynamic stability (shock/syncope/chest pain/pulmonary oedema)
if
Unstable ⇒ Immediate DC cardioversion
Rate/Rhythm Control + Anticoagulation (stroke prevention) is stable
AF <48 hrs ⇒ Rhythm control
AF >48 hrs ⇒
Rate control
tx should involve Assess haemodynamic stability (shock/syncope/chest pain/pulmonary oedema)
if
Unstable ⇒ Immediate DC cardioversion
Rate/Rhythm Control + Anticoagulation (stroke prevention) is stable
AF <48 hrs ⇒ Rhythm control
AF >48 hrs ⇒
Rate control
rate control over 48hr what is used
beta blocker - atenolol - dont use in COPD and astha or in hypotension
or CCB but dont use this in hear failure
line 2 is digonxin - aovid yoner patietns
when can you not use CCB
heart failure
when can you not use BB
asthma or COPD
ryhtm control comes before 48hrs what do you do
electricla cardioversion and a DOAC
flecainide - yougner patients
amiodarone - older
CHADS-VAS score of what means offer anticoauglation
A and S 2
2 or more
