Atrial arrhythmias

Question 1

flow of electrical signals

Answer 1

SA, AV, BH, BB, PF

Question 2

S1

Answer 2

systole; tricuspid and mitral close

Question 3

S2

Answer 3

diastole; aortic and pulmonary close

Question 4

atrial flutter

Answer 4

rapid but organized atrial electrical activity rising from one single foci
250-350 bpm; ventricular response in predictable
saw tooth waves on EKG (F waves)

Question 5

atrial fibrillation

Answer 5

rapid, uncoordinated atrial electrical activity rising from multiple foci
400-600 bpm; ventricular response is irregularly irregular
low electrical fibrillatory waves with irregular irregular QRS

Question 6

why do we care about atrial arrhythmias

Answer 6

blood clots form when blood becomes stagnant in the left atrial appendage due to lack of forceful pumping which then travels to the brain and causes a stroke

Question 7

incidence

Answer 7

age, HTN, obesity
also
CHF
valvular disease
COPD
hyperthyroidism
caffeine
alcohol (holiday heart)

Question 8

which arrhythmia is more common

Answer 8

atrial fibrillation

Question 9

sx mild severe

Answer 9

can be asymptomatic
mild: dizziness, fatigue, weakness
sever: syncope, dyspnea, angina

Question 10

lab tests

Answer 10

CBC
electrolytes
cardiac enzymes
thyroid
INR
EKG
Echocardiogram

Question 11

Pharm Tx

Answer 11

rate control (if >100 bpm): beta blockers (metoprolol) and calcium channel blockers (verapamil and diltiazem)
rhythm control: electro and pharmacological cardioversion
anticoagulants for 3 weeks prior to cardioversion if afib has been >48 hrs: Warfarin (Coumadin) dabigatran (Pradaxa) apixaban (Eliquis) and rivaroxaban (Xarelto)

Question 12

other tx

Answer 12

cardiac ablation
cardiac pacemaker
watchman procedure