Arrhythmias

Question 1

What is Atrial Fibrillation?

Answer 1

AF is where the heart beats abnormally fast

Question 2

How is AF managed?

Answer 2

Management involves either rate or rhythm control

Question 3

What should be assessed for patients with AF?

Answer 3

Assess risk of stroke and VTE (Venous thromboembolism)

Annual review for risk of bleeding, strokes and anti coagulation.

Question 4

What treatment would be used for new onset of AF with hemodynamic instability?

Answer 4

Emergency electrical cardioversion without anticoagulation

Question 5

What treatment would be given to patient with No haemodynamic instability?

Answer 5

Can be treated by Rate control or rhythm control.

Rate control preferred if patient presents with AF for more than 48hrs or is uncertain.

Question 6

Pharmacological Cardioversion methods

Answer 6

• IV Amiodarone or Flecainide
• Urgent control needed then IV beta blocker or Verapamil can be given

Question 7

What is the risk of stroke assessment called?

Answer 7

CHA2DS2 VASC assessment

Question 8

What risk factors are included in the CHA2DS2 VASC assessment?

Answer 8

Congestive Heart failure
Hypertension
Age (75 or over) x2
Diabetes
previous ischaemic Stroke/ Transient ischaemic attacks x2
Vascular disease
Age (65-74)
Sex Category (female)

Question 9

What score in CHA2DS2 VASC requires no treatment

Answer 9

0 for men

1 for women

Question 10

What do the other scores in CHA2DS2VASC mean

Answer 10

Score of 1 in men: consider DOAC
Taking bleeding risk into account

Score of 2 or higher in men/women: Offer DOAC (if contraindic: warfarin)
Taking bleeding risk into account