All about A-fib Flashcards by Lindsey Herrera

What test is used to verify and diagnose AF?

electrocardiogram (ECG)

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AF is a _____ tachycardia.

supraventricular

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

Rheumatic heart disease

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

Long-standing persistent AF

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How is AF prevented?

we don’t know

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What is Permanent AF?

persistent atrial fibrillation; no longer pursue a rhythm control strategy

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How often to AF pts need routine follow up?

every 12 mos if controlled

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

atrial and atrial appendage thrombus formation

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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?

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

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

pulmonary veins (PV)

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

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

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What is Long-standing persistent AF?

AF that has lasted for more than 12 months

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

absent

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AF is more prevalent in ____ and _____.

men; with increasing age

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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 ______.

the underlying disease as well as the AF

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What can precipitate AF?

exercise emotion EtOH

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

“irregularly irregular”

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

reduction in cardiac output

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What are the severe s/s of AF?

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

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You verify the AF diagnosis. What now?

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

How does the baseline appear in AF?

it’s undulating

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

rapid firing (or triggers)

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

afterdepolarizations

What are the common rate control strategies in AF?

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

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

a rate-control strategy

What are the common rhythm control strategies in AF?

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

AF is a supraventricular \_\_\_\_\_\_.

tachycardia

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

Persistent AF

What does "irregularly irregular" mean?

the spacing btw the R intervals is not uniform

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

re-entry

What are the typical s/s of AF?

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

What is subclinical AF?

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

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

younger than age 65

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

heart disease

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

Paroxysmal AF

What is Paroxysmal AF?

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

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

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

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

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

sinus rhythm is spontaneously restored

What is Persistent AF?

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

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

Hypertensive heart disease; coronary heart disease (CHD)

Name the 4 classifications of AF.

1. 2. Persistent AF 3, Long-standing persistent AF 4. Permanent AF

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

terminates spontaneously; persistent

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

Permanent AF

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

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

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

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

AF almost always occurs in association with \_\_\_\_\_.

structural heart disease

What comorbidities may lead to AF?

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

What is the most frequent major complication of atrial fibrillation?

systemic embolization and stroke