Atrial fibrillation Flashcards

1
Q

What is the definition of AF?

A

Irregularly irregular fast heart beat

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2
Q

What is the epidemiology of AF?

A

Common. Occurring in 1-2% of the general population

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3
Q

What is the pathology of AF?

A
  • Rapidly firing ectopic foci located inside 1 or more pulmonary veins
  • Abnormal atrial tissue substrate - ↑ atrial pressure, ↑ atrial muscle mass, atrial fibrosis, inflammation and infiltration of the atrium
  • Only a proportion of electrical impulses in the atria reach the ventricles
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4
Q

What are the risk factors/aetiology of AF?

A
  • Hypertension
  • Heart failure
  • Rheumatic heart disease
  • Cardiac conditions/ Valve disease: Sinus sick syndrome, Wolff-Parkinson-White syndrome, heart failure
  • Alcohol intoxication
  • Thyrotoxicosis
  • Hyperthyroidism
  • Caffeine
  • Smoking
  • Cardiac surgery
  • Idiopathic
  • Genetics/family history
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5
Q

What are the signs/symptoms of AF?

A
  • Palpitations
  • Fatigue
  • SOB
  • Chest pain
  • ↓ exercise capacity
  • Dizziness/syncope
  • Irregularly irregular pulse – maintained during exercise
  • Ventricular rate usually 120-180 beats per minute
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6
Q

What other diseases does AF present similarly to?

A
  • Atrial flutter
  • Atrial extrasystoles
  • Supraventricular tachyarrhythmias
  • Atrioventicular nodal re-entrant tachycardia
  • Wolff-Parkinson-White syndrome
  • Ventricular tachycardia
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7
Q

What investigations are conducted if AF is suspected?

A
  • ECG – fibrillation and no clear p waves, QRS rhythm is rapid and irregular
  • FBC
  • U&E
  • TFTs
  • CXR
  • Transthoracic echocardiography
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8
Q

What are the surgical treatments for AF?

A

• Cardioversion – electrical DC shock/IV drugs

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9
Q

What are the pharmacological treatments for AF?

A
  • Antiarrhythmic drug – Quinidine, Beta blockers, amiodarone
  • Rate controlling drugs – digoxin, beta blockers, Ca channel blockers
  • Oral anticoagulant e.g. warfarin, NOACs – need to be calculated by the CHA2DS2-VASc scoring system
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10
Q

What are the non pharmacological treatments for AF?

A

• Avoid alcohol/caffeine if possible

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