Atrial Fibrillation Flashcards
Atrial fibrillation
Definition?
Irregularly irregular atrial firing, atria are quivering/twitching
What is the MC cardiac arrhythmia?
A FIB
Causes of A fib?
Heart failure, HTN, 2^ to mitral stenosis, sometimes idiopathic, hyperthyroid, PE
RF?
60+, T2DM, HTN, Valve defects (mitral stenosis, history of MI
Pathology of AF?
Rapid reentrant ectopic foci (300-600bpm firing rate) cause atrial spasm
Not co ordinating contraction like typical physiological pathway
Symptoms?
Can be
Paroxysmal (episodic - comes & goes <1 week)
Persistent (longer than 7 days)
Permanent (sinus rhythm unrestored)
General fatigue, dizziness, SOB, weakness and palpitations ‘thumping’
What does ECG show?
Irregularly irregular pulse with narrow QRS (<120ms)
P waves (fibrillary squiggles)
Tx for stable long term AF?
rate control
lower HR = beta blockers or CCB (verapamil) + oral anticoagulant + (digoxin)
Surgical Tx for AF?
radio frequency ablation - restore normal PQRST shape
cardio version DC or pharmacological + warfarin
What score is used to assess stroke risk and if anti coag needed for AF?
CHA2DS2VASC score
What is the CHADSVAS score?
Congestive HF
Htn
Age >75 (2)
Diabetes
Stroke (2)
Vascular disease
Age (65-74)
Sex category (female)
2+ = oral anti coagulant needed
What is the HASBLED score?
assesses risk of major bleeds in AF patients on anticoags
> 3 score (max 9) = regular reviews
Complications of Af?
HF, ischemic stroke, mesenteric ischemia
