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CVPR Exam I > All about A-fib > Flashcards

All about A-fib Flashcards

1
Q

What test is used to verify and diagnose AF?

A

electrocardiogram (ECG)

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1
Q

AF is a _____ tachycardia.

A

supraventricular

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2
Q

______, although now uncommon in developed countries, is associated with a much higher incidence of AF.

A

Rheumatic heart disease

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2
Q

AF that has lasted for more than 12 months is called?

A

Long-standing persistent AF

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2
Q

How is AF prevented?

A

we don’t know

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3
Q

What is Permanent AF?

A

persistent atrial fibrillation; no longer pursue a rhythm control strategy

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3
Q

How often to AF pts need routine follow up?

A

every 12 mos if controlled

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5
Q

AF can have adverse consequences related to a reduction in cardiac output and to ______.

A

atrial and atrial appendage thrombus formation

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6
Q

Current data suggest that rhythm and rate control strategies are associated with similar rates of mortality and serious morbidity. As such, when would you choose a rhythm control strategy instead of rate control?

A

for symptom improvement with younger patient age in irreversible structural and electrical remodeling that occurs with longstanding persistent AF

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7
Q

AF is initiated by rapid firing (or triggers) from the _____.

A

pulmonary veins (PV)

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8
Q

AF is usually associated with some underlying heart disease. ____, ____, or _____ of the atria are often seen.

A

Atrial enlargement, an elevation in atrial pressure, or infiltration or inflammation

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9
Q

What is Long-standing persistent AF?

A

AF that has lasted for more than 12 months

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11
Q

AF is the most common cardiac arrhythmia. It has these characteristics: - RR interval: “irregularly irregular” - P wave: ______

A

absent

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11
Q

AF is more prevalent in ____ and _____.

A

men; with increasing age

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12
Q

If the AF is secondary to cardiac surgery, pericarditis, myocardial infarction (MI), hyperthyroidism, pulmonary embolism, pulmonary disease, or other reversible causes, therapy is directed toward ______.

A

the underlying disease as well as the AF

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12
Q

What can precipitate AF?

A

exercise emotion EtOH

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14
Q

AF is the most common cardiac arrhythmia. It has these characteristics: - RR interval: ______ - P wave: absent

A

“irregularly irregular”

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16
Q

AF can have adverse consequences related to a ______ and to atrial and atrial appendage thrombus formation.

A

reduction in cardiac output

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17
Q

What are the severe s/s of AF?

A

dyspnea at rest angina presyncope or infrequently, syncope an embolic event the insidious onset of right-sided heart failure

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18
Q

You verify the AF diagnosis. What now?

A
  1. determine need for anticoagulation therapy (CHA2DS2-VASC risk score) 2. decide rate vs rhythm control to slow the ventricular rate 3. cardioversion? 4. ablation?
18
Q

How does the baseline appear in AF?

A

it’s undulating

19
Q

AF is initiated by _____ from the pulmonary veins (PV).

A

rapid firing (or triggers)

19
Q

In many cases, arrhythmia is triggered by _____ but is maintained by re-entry.

A

afterdepolarizations

20
Q

What are the common rate control strategies in AF?

A

slow conduction across the atrioventricular (AV) node, using drugs like beta blockers, non-dihydropyridine calcium channel blockers (diltiazem or verapamil), or digoxin

21
Q

For asymptomatic or mildly symptomatic AF patients who are 65 years or older, we suggest _____ strategy using medical therapy (Grade 2B).

A

a rate-control strategy

22
Q

What are the common rhythm control strategies in AF?

A

antiarrhythmic drug therapy, percutaneous catheter ablation, and/or a surgical procedure

23
Q

AF is a supraventricular ______.

A

tachycardia

25
Q

This is AF that fails to self-terminate within seven days. Episodes often require pharmacologic or electrical cardioversion to restore sinus rhythm.

A

Persistent AF

26
Q

What does “irregularly irregular” mean?

A

the spacing btw the R intervals is not uniform

27
Q

In many cases, arrhythmia is triggered by afterdepolarizations but is maintained by _____.

A

re-entry

29
Q

What are the typical s/s of AF?

A

palpitations tachycardia fatigue weakness dizziness lightheadedness reduced exercise capacity increased urination mild dyspnea

31
Q

What is subclinical AF?

A

AF detected in asymptomatic individuals without a prior diagnosis- usually paroxysmal AF

32
Q

For most patients with AF who are _____, particularly those who are symptomatic, we suggest a rhythm control strategy (Grade 2B).

A

younger than age 65

33
Q

AF is usually associated with some underlying _____. Atrial enlargement, an elevation in atrial pressure, or infiltration or inflammation of the atria are often seen.

A

heart disease

34
Q

AF that terminates spontaneously or with intervention within seven days of onset and having episodes that may recur with variable frequency is called?

A

Paroxysmal AF

35
Q

What is Paroxysmal AF?

A

AF that terminates spontaneously or with intervention within seven days of onset. Episodes may recur with variable frequency.

36
Q

For _____ or _____, we suggest a rate-control as opposed to a rhythm-control strategy using medical therapy (Grade 2B).

A

asymptomatic; mildly symptomatic AF patients who are 65 years or older

36
Q

There will never be a _____ (heart sound) in A-fib, by definition.

A

S4

38
Q

Early in the course of AF the atrium is relatively healthy and as a result _____.

A

sinus rhythm is spontaneously restored

39
Q

What is Persistent AF?

A

AF that fails to self-terminate within seven days. Episodes often require pharmacologic or electrical cardioversion to restore sinus rhythm. While a patient who has had persistent AF can have later episodes of paroxysmal AF, AF is generally considered a progressive disease

40
Q

______ and ______ are the most common underlying disorders in patients with atrial fibrillation (AF) in developed countries.

A

Hypertensive heart disease; coronary heart disease (CHD)

42
Q

Name the 4 classifications of AF.

A
    1. Persistent AF 3, Long-standing persistent AF 4. Permanent AF
43
Q

As the substrate remodels further over time, AF no longer _____ and becomes _____.

A

terminates spontaneously; persistent

44
Q

This is persistent atrial fibrillation; no longer pursue a rhythm control strategy.

A

Permanent AF

45
Q

If the AF is secondary to _____ (7), therapy is directed toward the underlying disease as well as the AF.

A

cardiac surgery pericarditis myocardial infarction (MI) hyperthyroidism pulmonary embolism pulmonary disease other reversible causes

46
Q

What is the anticoagulant of choice for AF pts with a CHA2DS2-VASc score ≥2?

A

chronic warfarin or a NOAC (non-vitamin K oral anticoagulants like dabigatran, rivaroxaban, apixaban, or edoxaban)

47
Q

AF almost always occurs in association with _____.

A

structural heart disease

48
Q

What comorbidities may lead to AF?

A

cardiovascular or cerebrovascular disease diabetes hypertension chronic obstructive pulmonary disease hyperthyroidism excessive alcohol ingestion

49
Q

What is the most frequent major complication of atrial fibrillation?

A

systemic embolization and stroke

CVPR Exam I (29 decks)

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