Atrial fibrillation

Question 1

Risk factors for atrial fibrillation (9)

Answer 1

AF? DOC ACTS

Age
Family history

Diabetes
Obesity
Cardiovascular disease (HT, valvular disease, heart failure, cardiomyopathy, coronary artery disease, congenital heart disease, sarcoidosis/other inflammation of the heart)

Alcohol
COPD
Thyrotoxicosis
Sleep apnoea

Question 2

Valvular diseases associated with atrial fibrillation (4)

Answer 2

1. Mitral regurgitation
2. Mitral valve prolapse
3. Mitral stenosis
4. Tricuspid regurgitation

Question 3

Pathology of atrial fibrillation

Answer 3

Dilatation to fibrosis

Question 4

Drugs for rate control

Answer 4

1. Beta blockers (atenolol, metoprolol)
2. Central Ca2+ channel blockers (diltiazem, verapamil)
3. Digoxin

Question 5

Drugs for rhythm control

Answer 5

1. Amiodarone
2. Flecainide
3. Sotalol (maintenance)

Or DC cardioversion.

Remember TOE and anticoagulation

Question 6

Assessment and treatment guidelines for stroke risk

Answer 6

CHA2DS2VASc score

CHF
HT
Age >75 (2)
Diabetes
Stroke history (2)
Vascular disease
Age 65-74
Sex - female

0 - aspirin or nothing
1 - aspirin or warfarin/new anticoagulant
2 - warfarin/new anticoagulant (dabigatran, rivaroxaban, apixaban)