Atrial arrhythmias Flashcards
what are the 4 classifications of AF
first detected // paroxysmal // persistant // perminant
what is persistent AF
not self terminating and usually last 7+ days
presentation a fib
palpitations, dyspnoea, chest pain, irregularly, irregular pulse
how should a haemodynamically unstable AF patient be treated
shocks per ALS
how should AF within 48 hours of presentation be treated (broadly)
1)rhythm control 2) rate
how should AF presenting >48hours or uncertain timing be treated (broadly)
rate conrol
how long should late presenting AF patients be treated with anticoags before they are cardioverted
3 weeks
when would rate control not be 1st line in AF (4)
reversible cause // HF caused by AF // new onset (<48hrs) // Atrial flutter
rate control meds AF (3)
BB // CCB // digoxin
when are BB contraindicated
asthma
what rhythm control drugs for longterm AF (3)
BB // dronedarone // amiodarone (esp with HF)
when is catheter ablation for AF indicated
patients who have not responded to meds
what medication should be given for 4 weeks prior to AF catheter ablation
anticoags
complications of cathether ablation
tamponade // stroke // pulm vein stenosis
when may shocks be given in AF
haemodynamically unstable
what part of an. ECG is electrical cardioversion delivered to in AF
R wave
what drug should patients recieve prior to electrical cardioversion in AF if defo onset <48 hours
heparin
what drug can be used for cardioversion in AF
amiodarone or flecainide
in patients with onset >48hrs of AF what type of cardiversion is recommended
electrical
how long should patients with AF onset >48 hours be anticoagulated before and after electrical cardioversion
3 weeks before and at least 4 after
what score is used to determine risk of stroke/ need for anticoag in AF
CHA2DS2VASC
what are the RF in the scoring for anticoag in AF (7)
congestive HF // hypertension // age // diabetes // stroke prior // bascular disease // sex (female)
what scores for anticoag post AF would warrant treatment
0= none // 1 = coag for males // 2 = coag for males and females
if there is no indication for anticoag post AF what test must be done
echo to exclude valvular disease
what score is used to assess a patients risk of bleeding if started on anticoags post AF
ORBIT score
what components make up ORBIT (5)
ANEAMIE // RENAL IMPAIRMENT // age, platelet treatment, bleeding history
if anticoag treatment is indicated post AF what is 1st and 2nd line
1st = DOAC // 2nd = warfarin
if AF causes a TIA when should anticoag be started
immediately (DOAC)
if AF causes a stroke when should anticoag be started
antiplatelets 2 weeks –> anticoag
what needs to be ruled out before starting stroke/ TIA patients on anticoag
haemorrhage
what type of arrhythmia is atrial flutter
SVT
what ECG findings in atrial flutter
sawtooth // 150bpm
mx for atrial flutter
similar to AF - more sensitive to cardioversion
