Arrhythmias- 2

Question 1

What is AF?

Answer 1

Chaotic + disorganised atrial activity= irregular heartbeat.

Most common type of arrhythmia.

Question 2

What are the forms of AF?

Answer 2

1. Paroxysmal- Sudden onset, can be recurrent.
2. Persistent- AF episode > 48hrs. Needs pharmacological intervention to restore NSR.
3. Permanent- Medical intervention cannot restore NSR.

Question 3

Associated diseases/ causes of AF?

Answer 3

hypertension, CCF, Congenital heart disease, CHD, valvular heart disease.
Non cardiac- COPD, alcohol abuse, thyroid disease.

Question 4

What is lone (idiopathic) AF?

Answer 4

AF not related to/ caused by any other cardiac diseases. Significant stroke risk= if age over 75.

Question 5

What are the symptoms of AF?

Answer 5

• Palpatations
• Diziness
• Syncope
• Chest pain
• Dyspnoea
• Fatigue
• Sweat
  Can also be asymptomatic

Question 6

What is the main mechanism of AF?

Answer 6

Multiple waves of reentry

Question 7

ECG changes for AF?

Answer 7

1. Atrial rate (over 300bpm)
2. Ventricular rate- variable
3. Rhythm- Irregularly irregular
4. P wave abesnt

Question 8

What drug treatment must be given to ensure normal AV conduction in AF?

Answer 8

1. Rate control- B blocker, Ca blocker

2. Rhythm control- Cardioversion, amiodarone

Question 9

What is the ventricular rate dependant on?

Answer 9

• AV node conduction
• Para/sympathetic activity
• Drugs that act on AV node. (b block, ca block)

Question 10

What ventricular changes can be seen in AF?

Answer 10

Fast ventricular rate.

Can be slow if there is AVN block.

Question 11

What can be the physiological effect of AF on the body?

Answer 11

• Atria not contracting properly
• Ventricles not fully filled
• Reduced cardiac output
• CCF probable in diastolic dysfunction

If ventricular rate < 60bpm = AV conduction disease
Caution with AAD’s and rate controlling drugs

May need permanent pacing.