Atrial Fibrillation Flashcards

1
Q

Components of CHA2DS2VASc Score

A

C: Congestive HF
H: HTN
A: Age > 75 years (2 pts)
D: Diabetes
S: Stroke/TIA/Systemic Embolism (2 pts)
V: Vascular Disease
A: 75-74 years
Sc: Female

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2
Q

Anticoagulation indicated in men with a CHA2DS2VASc Score ≥ ___

A

<p>2</p>

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3
Q

<p>Anticoagulation indicated in women with a CHA2DS2VASc Score ≥ \_\_\_</p>

A

<p>3</p>

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4
Q

<p>HASBLED Componenets</p>

A

<p>H: HTN - SBP > 160 mm Hg<br></br>A: Abnormal liver/kidney function (1 each)<br></br>S: Stroke history<br></br>B: Bleeding history<br></br>L: Labile INR</p>

<p>E: Elderly > 65 years</p>

<p>D: Drug/Alcohol abuse (1 each)</p>

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5
Q

<p>Lenient Rate Control HR Goal</p>

A

<p>< 110 bpm</p>

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6
Q

<p>Patients who qualify for Lenient Rate Control</p>

A

<p>Asymptomatic <strong>AND </strong>EF > 40%</p>

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7
Q

<p>Strict Rate Control HR Goal</p>

A

<p>< 80 bpm</p>

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8
Q

<p>Patients who qualify for Strict Rate Control</p>

A

<p>Symptomatic <strong>OR</strong> EF ≤ 40%</p>

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9
Q

Type of Cardioversion in Hemodynamically Unstable Patient

A

Immediate DCCV

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10
Q

Typoe of Cardioversion in Symptomatic Patient Desite Rate Control

A

DCCV, Chemical Cardioversion, or Both

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11
Q

Type of Cardioversion in a Paitnet Unable to Achieve Rate Control

A

DCCV, Chemical Cardioversion, or Both

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12
Q

Type of Cardioversion in a Paitnet Unable to Achieve Rate Control

A

DCCV, Chemical Cardioversion, or Both

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13
Q

Vaughan-Williams Class I Anti-arrythmic Class

A

Sodium Channel Blockade

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14
Q

Vaughan-Williams Class I Anti-arrythmics

A

Ia: Disopyramide, quinidine, procainamide
1b: Lidoacine, mexiletine
1c: Flecainide, Propafenone

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15
Q

Vaughan-Williams Class II Anti-arrythmics Class

A

Beta-blockers

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16
Q

Vaughan-Williams Class III Anti-arrythmics Class

A

Potassium Channel Blockade

17
Q

Vaughan-Williams Class III Anti-arrythmics

A

Sotalol, dofetilide, amiodarone, dronedarone, ibutilide

18
Q

Vaughan-Williams Class IV Anti-arrythmic Class

A

CCB

19
Q

Antiarrythmics that can be used for ACUTE chemical cardioversion

A

Flecainide, propafenone, dofetilide, amiodarone, ibutilide

20
Q

Antiarrythmics that can be used for CHRONIC Rhythm Control

A

Flecainide, propafenone, sotalol, dofetilide, amiodarone, dronedarone

21
Q

Class IC Antiarrythmics Metabolism/DDI

A

CYP2D6

22
Q

Propafenone specific AE

A

Metallic Taste

23
Q

Dofetilide Initation

A

3 days inpatient

24
Q

Dofetilide DDI

A

Verapamil: decreases absorption
HCTZ: Impacts clearance/electrolytes
Metformin/Trimethoprim: Competes for active tubular secretion
Additive QT prolongation

25
Q

Dofetide CI Renal Funciton

A

< 20 mL/min

26
Q

Sotalol Initiaton

A

3-days inpatient

27
Q

Sotalol DDI

A

Additive QT prolongation

28
Q

Sotalol CI Renal Function

A

< 40 mL/min

29
Q

Amiodarone Half-Life

A

~50 days

30
Q

Amiodarone DDI

A

Inhibits: CYP3A4, 2D6, 2C9, PGP
Additive QT prolongation

31
Q

Amiodarone load goal

A

8-10 grams over 2-4 weeks

32
Q

Amiodarone AEs

A
  1. Bradycardia
  2. QT prolongation
  3. Pulmonary fibrosis
  4. Thyroid dysfunction (hypo or hyper)
  5. Corneal deposits
  6. Hepatotoxicity
  7. Blue/Gray Skin
33
Q

Amiodarone Monitoring

A
  1. Baseline ECG, Q3-6 months
  2. Baseline TFTs, Q6 months
  3. Baseline LFTs, Q6 months
  4. Baseline CXR, Q12 months
  5. Baseline PFTs, Q12 months
34
Q

Dronedarone Brand

A

Multaq

35
Q

Dronedarone CI

A

HF, permanent AF

36
Q

Dronedarone metabolism/DDI

A

Inhibits: CYP3A4, 2D6, PGP
Additive QT prolongation

37
Q

Dronedarone AE

A
  1. Bradycardia
  2. QT prolongation
  3. Hepatotoxicity