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: 65-74 years
Sc: Female

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2
Q

Anticoagulation indicated in men with a CHA2DS2VASc Score ≥ ___

A

2

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3
Q

Anticoagulation indicated in women with a CHA2DS2VASc Score ≥ ___

A

3

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4
Q

HASBLED Componenets

A

H: HTN - SBP > 160 mm Hg
A: Abnormal liver/kidney function (1 each)
S: Stroke history
B: Bleeding history
L: Labile INR
E: Elderly > 65 years
D: Drug/Alcohol abuse (1 each)

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5
Q

Lenient Rate Control HR Goal

A

110 bpm

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6
Q

Patients who qualify for Lenient Rate Control

A

Asymptomatic AND EF > 40%

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7
Q

Strict Rate Control HR Goal

A

< 80 bpm

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8
Q

Patients who qualify for Strict Rate Control

A

Symptomatic OR EF ≤ 40%

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9
Q

Type of Cardioversion in Hemodynamically Unstable Patient

A

Immediate DCCV

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10
Q

Type 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 Patient Unable to Achieve Rate Control

A

DCCV, Chemical Cardioversion, or Both

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12
Q

Type of Cardioversion in a Patient Unable to Achieve Rate Control

A

DCCV, Chemical Cardioversion, or Both

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13
Q

Vaughan-Williams Class I Anti-arrhythmic Class

A

Sodium Channel Blockade

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14
Q

Vaughan-Williams Class I Anti-arrhythmics

A

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

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15
Q

Vaughan-Williams Class II Anti-arrhythmics Class

A

Beta-blockers

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16
Q

Vaughan-Williams Class III Anti-arrhythmics Class

A

Potassium Channel Blockade

17
Q

Vaughan-Williams Class III Anti-arrhythmics

A

Sotalol, dofetilide, amiodarone, dronedarone, ibutilide

18
Q

Vaughan-Williams Class IV Anti-arrhythmic Class

19
Q

Antiarrhythmics that can be used for ACUTE chemical cardioversion

A

Flecainide, propafenone, dofetilide, amiodarone, ibutilide

20
Q

Antiarrhythmics that can be used for CHRONIC Rhythm Control

A

Flecainide, propafenone, sotalol, dofetilide, amiodarone, dronedarone

21
Q

Class IC Antiarrythmics Metabolism/DDI

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
Dofetide CI Renal Funciton
< 20 mL/min
26
Sotalol Initiaton
3-days inpatient
27
Sotalol DDI
Additive QT prolongation
28
Sotalol CI Renal Function
< 40 mL/min
29
Amiodarone Half-Life
~50 days
30
Amiodarone DDI
Inhibits: CYP3A4, 2D6, 2C9, PGP Additive QT prolongation
31
Amiodarone load goal
8-10 grams over 2-4 weeks
32
Amiodarone AEs
1. Bradycardia 2. QT prolongation 3. Pulmonary fibrosis 4. Thyroid dysfunction (hypo or hyper) 5. Corneal deposits 6. Hepatotoxicity 7. Blue/Gray Skin
33
Amiodarone Monitoring
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
Dronedarone Brand
Multaq
35
Dronedarone CI
HF, permanent AF
36
Dronedarone metabolism/DDI
Inhibits: CYP3A4, 2D6, PGP Additive QT prolongation
37
Dronedarone AE
1. Bradycardia 2. QT prolongation 3. Hepatotoxicity