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Cardiology > Atrial Fibrillation > Flashcards

Atrial Fibrillation Flashcards

1
Q

What is atrial fibrillation?

A

Irregular and often fast heart rate

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2
Q

Causes of AF?

A 
Cardiac problems:
CAD
MI
Heart valve problems
Hypertension
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3
Q

What is paroxysmal AF?

A

AF that begins and stops on its own within 7 days

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4
Q

What is persistent AF?

A

AF that persists for more than 7 days or that has required cardioversion for termination of the rhythm

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5
Q

What is permanent AF?

A

AF that is present all the time

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6
Q

AF on an ECG?

A

No visible P waves and an irregularly irregular QRS complex

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7
Q

Management of patient in AF who is haemodynamically unstable

A

DC cardioversion

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8
Q

Management of patient in AF and haemodynamically stable?

A

Check anticoagulation status

If already on anticoagulants - immediate/delayed cardioversion
If not on anticoagulants - initiate anticoagulation

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9
Q

Management of haemodynamically stable patients with symptomatic AF of >48 hours?

A

Rate control e.g. beta-blockers

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10
Q

Management of haemodynamically stable patients with symptomatic AF of <48 hours

A

Early cardioversion

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11
Q

3 forms on management in AF?

A

Rate-control
Rhythm control
Anticoagulation

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12
Q

Symptoms of AF?

A

Asymptomatic
Palpitations
Shortness of breath

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13
Q

Signs of AF?

A

Irregularly irregular pulse
Absent ‘a’ wave on JVP: corresponds to atrial contraction
Tachycardia

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14
Q

Rate-control drugs?

A

Beta-blockers (e.g. metoprolol, bisoprolol)
Rate-limiting calcium channel blockers (e.g. verapamil, diltiazem)
Digoxin: usually reserved for patients that do no or very little physical exercise (e.g. bedbound) or other drugs are inappropriate (contraindicated, side-effects, patient preference).

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15
Q

Rhythm control (cardioverting) drugs?

A

Pharmacological: amiodarone, flecainide, beta-blockers (e.g. sotalol).
Electrical: DC cardioversion

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16
Q

Patients who may be suitable for rhythm control?

A 
New-onset AF
Identifiable reversible cause
Heart failure(exacerbated by AF)
Associated with atrial flutter(and ablation strategy appropriate)
Rhythm control felt more suitable
17
Q

Purpose of anti-coagulation in patient with AF?

A

Patients with AF are at increased risk of thromboembolic events due to stasis of blood and formation of clots, predominantly in the left atrial appendage

18
Q

How to assess stroke risk in patients with AF?

A

CHA2DS2-VASc

19
Q

How to assess stroke risk in patients with AF?

A

CHA2DS2-VASc score - anyone who scores 2 or more gets a DOAC

This is balanced with

ORBIT score - this measures bleeding risk and has replaced HAS-BLED

Cardiology (10 decks)

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