Atrial Fibrillation Flashcards
AF is the most common sustained cardiac arrythmia. T/F?
True
What is the major risk with AF?
Stroke
What are the possible symptoms of AF?
Palpitations Dyspnoea Chest pain Syncope Complications such as stroke
On examination how is the pulse in a patient with AF classically described?
Irregularly irregular
What test is used to confirm an irregularly irregular pulse as AF?
ECG
AF can be paroxysmal or persisting. T/F?
True
Why might ambulatory ECG be required to diagnose AF?
AF can. be paroxysmal
What signs of AF will be seen on ECG?
Irregularly irregular heart rate
Narrow QRS complexes
No P waves
‘Saw-tooth’ electrical activity on an ECG is characteristic of…?
Atrial flutter
Other than ECG, what tests should be conducted for AF?
TFTs
LFTs
Echocardiogram
What conditions can predispose to AF?
Hypertension Symptomatic heart failure Valvular heart. disease Cardiomyopathies Atrial septal defect / other congenital defect Coronary artery disease Thyroid dysfunction Obesity Diabetes mellitus COPD Sleep apnoea Chronic renal disease
What are the objectives of treatment in AF?
Prevention of stroke Relief of symptoms Management of concomitant CVD Control heart rate Possibly also control heart rhythm
What is the target heart rate for patients with AF?
<110/min
If symptomatic, what is the target heart rate for patients with AF?
<80/min
What are the major risk. factor for stroke in AF patients?
Previous stroke
TIA or systemic embolism
Age >75 years
What are the minor risk. factor for stroke in AF patients?
CHF or moderate to severe LV systolic. dysfunction Hypertension Diabetes mellitus Female. sex Age 65-74 Vascular disease
Risk factors for stroke in AF patients are collated via which scoring system?
CHADS-VAS
How are patients with AF treated to. prevent stroke?
Anticoagulation - warfarin or DOACS
Which AF patients should be referred for specialist assessment?
Still symptomatic despite adequate rate control
Young age <60
Inadequate rate control despite beta blocker/clacium antagonist and digoxin
Structural heart disease on echo
AF and coexisting herat failure
What medications are used for the symptomatic management of AF?
Beta blocker or calcium. antagonist
Digoxin
For which AF patients I rhythm control particularly important?
Younger patients
Ongoing symptoms despite good rate control
What are the options for rhthym control in AF patients?
Direct current cardioversion
Antiarhthymics
Catheter ablation
What potential side effect of amiodarone can, in itself, cause AF?
Thyroid dysfunction
What antiarrhthymic drugs can be used to treat AF?
Sodium channel blockers (flecainide, propafenone)
Potassium channel blockers (sotalol, amiodarone)
Multi-channel blockers (dronedarone)
What is the most effective management for rhthym control in AF patients with structurally normal hearts or minimal heart disease?
Catheter ablation
