Atrial fibrillation

Question 1

What is atrial fibrillation?

Answer 1

Supraventricular tachyarrhythmia that is characterized by uncoordinated atrial activation resulting in an irregular ventricular response

Question 2

What are the causes of AF?

Answer 2

(Unknown cause)

(Risk factors) Coronary heart disease, Hyperthyroidism, , age, hypertension

Question 3

What are the clinical features of atrial fibrillation?

Answer 3

Mostly asymptomatic 
 palpitations
dizziness
syncope
fatigue
dyspnea
tachycardia (irregularly irregular)

Question 4

How is atrial fibrillation diagnosed?

Answer 4

(ECG) Irregularly irregular RR intervals, P-waves scribbles, Tachycardia, Narrow QRS complex
(Echocardiography)

Question 5

What is the treatment for atrial fibrillation?

Answer 5

Treatment aims to control heart rate and/or rhythm + coagulation
Most try rate control, certain sub-groups have rhythm

Question 6

What is rate control in atrial fibrillation?

Answer 6

(Medication controlling rate) beta-blockers
calcium channel blockers
digoxin
(Medication maintaining sinus rhythm) sotalol
amiodarone
flecainide

Question 7

What is the coagulation treatment in AF?

Answer 7

CHA2DS2-VASc scoring system
IV heparin or LMWH
(direct thrombin inhibitors) e.g. dabigatran
(factor Xa inhibitors) e.g., rivaroxaban, apixaban

Question 8

What is rhythm control in atrial fibrillation?

Answer 8

Electrical cardioversion as an emergency or electrical or pharmacological cardioversion as an elective procedure
(pharmacology) flecainide or amiodarone
(direct current cardioversion)