Atrial Fibrillation Flashcards
Describe the pattern of atrial firing rhythm in atrial fibrillation
Irregularly irregular
What is the most common cardiac arrhythmia?
Atrial fibrillation
Name some types of tachycardias
Atrial fibrillation
Atrial flutter
WPW
VFib
What are causes of atrial fibrillation?
Heart failure
hypertension
AF secondary to mitral stenosis
Sometimes idiopathic
What are some risk factors for atrial fibrillation?
60+ y/o
DMT2
Hypertension
Valve defects (mitral stenosis)
History of MI
In atrial fibrillation there are rapid re-entrant ectopic foci which cause a_____ s____
atrial spasm (not co-ordinating contraction like typical physiology pathway)
What is the firing rate of atrial fibrillation causing the atrial spasm?
300-600 bpm
The atrial spasm in AFib causes atrial blood to ____ instead of pump efficiently into ventricles
pool
In AFib, blood pooling causing decreased __ and increased risk of __________ events
CO
thrombo-embolic
What are symptoms of AFib?
Palpitations
Irregularly irregular pulse
Thrombo-emboli eg. ischaemic stroke
Chest pain
Syncope
Hypotension
What does paroxysmal mean?
Episodic
True or false: atrial fibrillation can be paroxysmal, p____ (lasting longer than 7 days) or p____ (sinus rhythm is un-restorable)
persistent
permanent
How is AFib diagnosed?
ECG:
Irregularly irregular pulse
Narrow QRS (under 120ms)
No P waves (instead see fibrillatory squiggles)
What is treatment for unstable atrial fibrillation with syncope/ shock/ chest pain / heart failure?
DC synchronised cardioversion
Delivery of a controlled electrical shock under anaesthesia to reset heart’s electrical activity and establish sinus rhythm
What is treatment for stable long term atrial fibrillation?
Beta-blocker or CCB (rate control)
and DOAC (reduce risk of embolism)
or
DC cardioversion and warfarin
What is surgical treatment for atrial fibrillation?
Radiofrequency ablation
What tool helps to measure stroke risk in patients with atrial fibrillation and whether anticoagulation is needed?
CHA2DS2 -VASc score
What does CHA2DS2-VASc stand for?
Congestive heart failure
Hypertension
Aged 75+ (2 points)
Diabetes
Stroke (2 points)
Vascular disease
Age 65-74
Sex category = female
What score of CHA2DS2-VASc indicates anticoagulants are required?
2 or more
What score assess the risk of major bleeds in AF patients on anticoagulation?
HASBLED
What score is HASBLED out of?
9
What score of HASBLED indicates regular reviews are needed due to risk of major bleeds as patient is on anticoagulants for AFib?
3 or more
What are complications of atrial fibrillation?
Heart failure
Ischaemic stroke
Mesenteric ischemia (inadequate blood flow to intestines due to irregular heart rhythm)
