Atrial Fibrillation Flashcards
what happens to the p waves?
dont have any
what is paroxysmal AF?
AF lasting less than 48 hours
Paroxysmal atrial fibrillation is usually associated with _____ hearts
Paroxysmal atrial fibrillation is usually associated with normal hearts
what is persistent AF?
An episode of AF lasting greater than 48 hours, which can still be cardioverted to NSR
persistent AF is unlikely to spontaneously revert to ___
unlikely to spontaneously revert to NSR
what is permanent AF?
Inability of pharmacologic or non-pharmacologic methods to restore NSR
chronic atrial fibrillation is usually associated with ___ _____
chronic atrial fibrillation is usually associated with heart disease.
The ____-of AF is prolonged after AF has been maintained for progressively ______ periods of time.
The duration of AF is prolonged after AF has been maintained for progressively longer periods of time.
what are the cardiac causes/associated diseases of AF? 8
- hypertension
- CCF
- Sick SInus rhythm
- CHD
- thyroid disease
- familial
- valvular HD
- WPW
what are the noncardiac causes/associated diseases of AF? 8
- COPD
- Pneumonia
- septicaemia
- pericarditis
- tumours
- electrolyte disturbances
- alcohol abuse
- obesity
what are the symptoms of AF? 7
- palpitations
- presyncope (dizziness
- syncope
- chest pai
- dyspnoea
- sweatiness
- fatigue
The symptoms of AF are often ____ at the onset - i.e when switching from one rhythm to another
The symptoms of AF are often worse at the onset - i.e when switching from one rhythm to another
what is the mechanism of AF?
multiple wavelets of reentry
where is the ectopic focus of AF?
around the pulmonary veins
what is the rhythm of AF?
irregularly iregular
the ventricular rate on ECG depends on: 3 things
- AV node conduction properties
- Sympathetic and parasympathetic tone
- Presence of drugs with act on the AV node
For patients with hypertrophic cardiomyopathy, loss of atrial kick and decreased filling times can result in __________ especially in the presence of diastolic dysfunction
For patients with hypertrophic cardiomyopathy, loss of atrial kick and decreased filling times can result in congestive heart failure especially in the presence of diastolic dysfunction
Ventricular rates
Ventricular rates
AF in patients with preexcitation (__________) can result in ______ _____and sudden cardiac death.
AF in patients with preexcitation (Wolff-Parkinson-White Syndrome) can result in ventricular fibrillation and sudden cardiac death.
Preexcitation of the ventricles _______ the QRS via an ________ pathway.
Preexcitation of the ventricles broadens the QRS via an accessory pathway.
management is targeted at 2 things?
rhythm control and rate control
how is rhythm control managed
through either phamacological cardioversion of DCCV
what drugs can be used to control rhythm?
amiodarone, fleccainide, sotalol
AADs can be used before or after ___to maintain SR
before or after DC to maintain SR
how is rhythm maintained?
AADs
catheter ablation of atrial focus, pulmonary veins
surgery
what is the purpose o surgery?
to modify the atria so it can’t sustain AF rhythm
what is the objective of Rate control?
accept AF if nothing is changing but control ventricular rate and prevention of thromboembolism
what pharmacologic therapy/ can be used to slow the rate?
digoxin and adenosine
beta-blockers
verapamil, diltiazem
what 3 things are commonly used to treat AF?
external cardioversion, AAD and anticoagulation
what are the indications for anticoagulation in valvular AF?
mitral valve disease
what are the indications for anticoagulation in non valvular AF? 6
Age >75 Hypertension Heart failure Previous stroke/ thromboembolism CAD / DM
what is the mneumonic for bleeding risk assessment?
HASBLED
what are the aims of radiofrequency ablation in AF?
- rate control - ablation of AVN
to maintain SR - pulmonary veins
