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Cardiology > Atrial fibrillation > Flashcards

Atrial fibrillation Flashcards

1
Q

ECG signs of atrial fibrillation (3)

A

Chaotic baseline
Irregularly irregular QRS complexes
No P-waves

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2
Q

Common secondary causes of AF (4)

A

Pneumonia
Thyrotoxicosis
Hypertension
Valve disease

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3
Q

What is sick sinus syndrome?

A

Ischaemia/infarction/fibrosis of the sinus node, presenting with bradycardia and intermittent tachycardia

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4
Q

What are the two “arms” of treatment in AF?

A

Rate/rhythm control

Anticoagulation

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5
Q

Why do patients with AF often need to anticoagulated?

A

Turbulent blood flow in the heart increases risk of clot formation, and therefore increases risk of stroke

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6
Q

Options for rate control in atrial fibrillation?

A

Beta-blockers
Verapamil/diltiazem
Digoxin

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7
Q

Why would amlodipine not be useful for management of AF?

A

Amlodopine is a dihydropiridine-these have more of an effect on the vasculature rather than the heart

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8
Q

What are the pharmacological effects of digoxin? (2)

A

Negatively chronotropic- reduces heart rate

Positively inotropic- increases heart contractility

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9
Q

When is digoxin contraindicated?

A

Patients with second degree/complete heart block

Patients with ventricular arrythmias

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10
Q

What effect does potassium concentration have on digoxin activity?

A

Low K+ levels increase the effects of digoxin

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11
Q

Why is digoxin dose reduced in renal failure?

A

Digoxin is renally excreted

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12
Q

Rhythm control options in AF (2)

A

DC cardioversion

Pharmacological cardioversion

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13
Q

What tool is used to assess stroke risk in AF?

A

CHADS2VASC

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14
Q

What tool is used to assess the risk of bleeding in patients who are being anticoagulated?

A

HAS-BLED

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15
Q

What CHADSVASC score should prompt anticoagulation?

A

2 or above, taking HAS-BLED score into account

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16
Q

Complications of AF

A

Stroke

Heart failure

17
Q

Management of acute AF (less than 48 hours since onset)

A

If ill or haemodynamically unstable- emergency cardioversion, or amiodarone

Control the rate (verapamil, beta blocker) and give LMWH

18
Q

Management of atrial flutter

A

Rate/rhythm control as for AF

Sinus node catheter ablation

19
Q

Pharmacological cardioversion drugs? (2)

A

Amiodarone/flecainide if no evidence of structural/ischaemic heart disease

Otherwise- amiodarone

20
Q

When is digoxin indicated for rhythm control in AF?

A

In sedentary patients with non-paroxysmal AF

Cardiology (21 decks)

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