Atrial Fibrillation Flashcards
What is Atrial Fibrillation?
Cardiac arrhythmia, characterised by irregularly irregular ventricular pulse and loss of association between the cardiac apex beat and radial pulsation
What are the risk factors for AF?
Coronary heart disease HTN VHD Hyperthyroidism Cardiomyopathy Thyroxine Acute Infection Excessive caffeine/alcohol intake
How can AF be classified?
Acute Paroxysmal Recurrent Persistent Permanent
What is acute AF?
Onset w/i previous 48hrs
What is paroxysmal AF?
Spontaneous termination w/i 7/7
What is recurrent AF?
> 2 episodes, which may be defined as paroxysmal or persistent
What is persistent AF?
Not self-terminating, lasting >7days
What is permanent AF?
Long-standing (>1yr) not terminated by cardioversion
What are the sx of AF?
Dyspnoea Palpitations Syncope Chest discomfort Stroke/TIA
What investigations are appropriate in suspected AF?
ECG
FBC, U&Es, TFTs, LFTs, coag screen
Echo
CXR
What are the two management strategies for AF?
Rate control (1st line) Rhythm control
What medications are used for rate control?
B-blocker (bisoprolol) OR rate-limiting CCB (Verapamil)
-can be used in combination w/ digoxin
What is the therapeutic target for rate control?
60-80bpm at rest
When is rhythm control indicated?
Younger patients w/ new onset AF
Evidence of reversible causes
AF causing heart failure
How is rhythm control performed?
Cardioversion can be:
- Pharmacological (flecanide, amiodarone)
- Electrical
