Atrial fibrillation

Question 1

Definition

Answer 1

Irregular and often rapid heart rhythm that can lead to blood clots in the heart.
occurs in older patients more
younger patients- paroxysmal form (attacks)

Question 2

Aetiology

Answer 2

Any condition resulting in increased atrial pressure etc can cause atrial fibrillation
- coronary heart disease
- heart attack
- heart valve problems
- previous heart surgery
- viral infections

Most common causes:
- hypertension
- heart failure

‘Classic’ causes:
- rheumatic heart disease
- alcohol consumption
- thyrotoxicosis

Hyperthyroidism may trigger atrial fibrillation

Question 3

Epidemiology

Answer 3

Common arrythmia occurring in 1-2% of population 5-15% people over 75.

Question 4

Risk factors

Answer 4

Age- older=more likely
hypertension
obesity
alcohol
family history
thyroid disease

Question 5

Clinical presentation

Answer 5

Symptoms can be variable

people can suffer with:
- rapid palpitations
- dyspnoea and chest pain
- dizziness
- fatigue
- weakness
- deterioration of exercise capacity or wellbeing
- ‘ireggular irregular’ pulse, with the irregularity being sustained during exercise

untreated ventricular rate is 120-180/min- this will slow with treatment

Question 6

Classification of atrial fibrillation

Answer 6

Paroxysmal- stops spontaneously within 7 days

Persistent- continuous >7 days

Longstanidng persistent- continuous >1 year

permanent- continuous, stop treating as its not getting better