Arrhythmia 2 Flashcards
What is the ‘typical’ patient of AF?
60 yr old female
Hypertensive
Palpitations, SOB and fatigue
Slide 4
What indicates left ventricular hypertrophy on an ECG?
When the R waves are very tall on 3 consecutive chest leads. Slide 5
What is AF and how does it arise?
Chaotic and disorganised atrial activity with an irregular heartbeat.
It arises from ectopic foci in muscle sleeves of the pulmonary veins and causes the atria to disorganisely contract
Slide 6+7
What are the 3 forms of AF?
Paroxysmal - Lasts <48hrs
Persistent - Lasts>48hrs and can be be converted back to normal sinus rhythm,
Permanent - Cannot be reverted back to normal sinus rhythm.
Slide 9
What other diseases can be associated with AF?
Hypertension Coronary heart disease Sick Sinus syndrome Obesity Thyroid disease Cardiac Valve disease Alcohol abuse Congenital COPD, pneumonia Tumours. Slide 10
What is idiopathic AF?
Absence of any heart disease or ventricular dysfunction. Slide 11
What are the symptoms of AF?
Palpitations Dizziness Syncope Chest pain Dyspnoea Sweatiness Fatigue. Slide 12
On an ECG how does AF present?
Atrial rate of >300bpm Irregularly irregular No p waves F waves present Slide 13
AF can cause the ventricular rate to be slow. True or False?
True, can have periods of fast or slow Ventricular rate. Slide 16
What is pseudo-regularisation?
When the ECG appears tachycardic but until you look at the rhythm strip you see there is an irregular rhythm. Slide 17
How is AF managed?
Manage the rhythm
- Direct current cardioverson
- Anti-arrhythmic drugs
Manage rate and have to make sure the ventricular rate is managed
-Digoxin, B blockers, verapamil
Slide 19-21
What are the anti-arrhythmic drugs?
Class 1: Na channel current -Lignocaine, flecainide Class II: B adrenergic antagonists -Propranalol Class III: Action potential prolongation -Amiodarone, sotalol, Dronedarone Class IV: Ca Channel antagonists -Verapamil. Slide 24
Why do anticoagulents may need to be administered in AF?
If there is indication for coagulation risk
As there is stasis due to AF and can increase the risk of stroke. Slide 28
What interventions can be done for AF?
Radiofrequency ablation
Left atrial catheter ablation
Slide 31+32
What is atrial flutter?
Rapid and regular form of atrial tachycardia which usually progresses to AF.
Caused by a macro re-entrant circuit. Slide 35+38
