Arrhythmias and Anticoagulants Flashcards
What is an arrhythmia?
Refers to any change in the normal rate or rhythm of the heart
Why do arrhythmia occur?
- Altered impulse generation: changes in the automaticity of the pacemaker cells in the SAN
- Altered impulse conduction: complete / partial block of conduction pathways
What are the types of arrhythmia?
- Bradycardia
- Tachycardia
- Atrial Flutter
- Atrial Fibrillation
What are the symptoms of Atrial Fibrilation?
- Breathlessness
- Light headedness
- Fatigue
- Palpitations
- Chest Pain
What are class Ia. Ib and Ic drugs?
Na channel blockers
What are class II drugs?
Beta-adrenoreceptor blocker
What are class III drugs?
K+ channel blockers - prolongs action potential
What are class IV drugs?
Ca2+ channel blockers
What are the types of AF?
- Paroxysmal (termination within 7 days)
- Persistant (7 days+)
- Permanent (1 year+)
What is the first line strategy for AF patients?
Rhythm control
- Cardioversion
- Amiodarone therapy
Drug treatment
- Beta blocker
- Dronedarone
What are the adverse effects of amiodarone?
- Interstital pulmonary fibrosis
- GIT intolerance
- Tremor, dizziness
- Hyperthyroidism
- Liver toxicity
- Photosensitivity
- Neuropathy
- Blue skin discolouration
What is amiodarone?
It is a class III drug, delays phase 3 (repolarisation)
What is the normal INR?
1
What is the normal INR for AF patients?
2-3
What is the normal INR for patients with a mechanical heart valve?
2.5-3.5
