Arrythmias Flashcards
What are the 2 aims of AF treatment?
To prevent symptoms and complications (stroke)
What do you do if patient has poor AF symptom control?
Refer within 4 weeks
What is ablation surgery for arrythmias?
Burns / cuts off abnormal electrical signalling pathways
What 2 risks need to be assessed annually for all AF patients?
Bleeding and stroke risk - these can tell you about how much anticoagulation is needed
What is the treatment of acute AF?
if life threatening - emergency electrical cardioversion
If non-life threatening
Within 48 hrs - offer rate or rythm control
If arrythmia still occuring after 48 hours - consider adding electrical cardioversion after rate control.
How long should a patient be antocoagulated after electrical cardioversion?
At least 4 weeks after.
What is maintenance AF treatment? (3 steps)
- Rate control with BB or rate limiting CCB
- Combo of 2 drugs (BB, rate limiting CCB and digoxin)
- If combo failed, rhythm control considered (amiodarone and sotalol, fleclanide)
Which BB is used for rhythm control but not rate control?
Sotalol
When is oral amiodarone used for AF?
Started before electrical cardioversion and up to 12 months after to maintain normal heart rhythm.
When is amiodarone preferred other anti arrythmics?
When there is structural or ischaemic heart disease.
Which drugs are pereffed in AF with concomitant HF?
BB (licenced for HF) + digoxin,
What is pill In the pocket for paroxysmal AF?
Flecainide or profenerone (Oral anti-arryrhmics) in the pocket for infrequent AF episodes.
What tools are used for anticoagulation?
CHADVASC - STROKE RISK
HABLED / ORBIT - BLEEDING RISK
What drugs are used for anticoagulation and when?
Valvular AF - warfarin
Non- valvular AF - DOACS
Also those waiting electrical cardioversion - fiblriating over 48 hrs
Why is aspirin not used for stroke prevention in AF?
Less effective than warfarin but carries bleeding risk
Never offered for monotherpay in AF
