Atrial Fibrillation AF Flashcards
What is atrial fibrillation (AF)?
AF is a supraventricular arrhythmia characterised by an irregularly irregular rhythm and the absence of distinct P waves on an ECG.
What are the common types of AF?
Paroxysmal (self-terminates within 7 days), persistent (lasts >7 days or requires intervention), and permanent (accepted as the long-term rhythm).
What are the main symptoms of AF?
Symptoms include palpitations, dizziness, breathlessness, fatigue, and, in severe cases, syncope or angina.
What are the common causes of AF?
Causes include hypertension, coronary artery disease, valvular heart disease, heart failure, hyperthyroidism, and excessive alcohol consumption.
What is the pathophysiology of AF?
Disorganised atrial electrical activity leads to ineffective atrial contraction, causing stasis of blood in the atria and an irregular ventricular response.
What are the risk factors for developing AF?
Age, hypertension, obesity, diabetes, heart disease, excessive alcohol intake, and sleep apnoea.
How is AF diagnosed?
AF is diagnosed using ECG, which shows an irregularly irregular rhythm and absence of P waves, replaced by fibrillatory waves.
What are the complications of untreated AF?
Complications include stroke, thromboembolism, heart failure, and reduced quality of life.
What is the role of echocardiography in AF?
Echocardiography assesses atrial size, ventricular function, valvular disease, and the presence of thrombi.
What is the CHA₂DS₂-VASc score?
It estimates stroke risk in patients with AF and guides decisions about anticoagulation therapy.
What are the components of the CHA₂DS₂-VASc score?
Components include Congestive heart failure, Hypertension, Age ≥75 years (2 points), Diabetes, Stroke/TIA (2 points), Vascular disease, Age 65-74, and Sex category (female).
What is the HAS-BLED score?
It assesses bleeding risk in patients with AF who are being considered for anticoagulation.
What are the goals of AF management?
To control symptoms, prevent thromboembolism, and manage underlying conditions.
What are the two main strategies for managing AF?
Rate control and rhythm control.
What medications are used for rate control in AF?
Beta-blockers (e.g., bisoprolol), calcium channel blockers (e.g., diltiazem), or digoxin.
What medications are used for rhythm control in AF?
Antiarrhythmics like amiodarone or flecainide are used to restore and maintain sinus rhythm.
What is electrical cardioversion, and when is it used?
Electrical cardioversion is a procedure using synchronised shocks to restore sinus rhythm in symptomatic or persistent AF.
When is anticoagulation recommended in AF?
Anticoagulation is recommended for patients with a CHA₂DS₂-VASc score of ≥1 in men or ≥2 in women.
What are the common anticoagulants used in AF?
Direct oral anticoagulants (DOACs) like apixaban and rivaroxaban or vitamin K antagonists like warfarin.
What are the indications for catheter ablation in AF?
Symptomatic AF refractory to medical therapy or as a first-line option in selected patients.
What lifestyle changes are recommended for patients with AF?
Weight management, reducing alcohol intake, smoking cessation, managing hypertension, and regular physical activity.
What is the role of left atrial appendage occlusion in AF?
It is a non-pharmacological option to reduce stroke risk in patients who cannot tolerate anticoagulation.
What is lone AF?
Lone AF refers to AF occurring in younger patients without identifiable risk factors or structural heart disease.
How does AF increase stroke risk?
AF causes stasis of blood in the atria, particularly in the left atrial appendage, leading to thrombus formation and potential embolism.
Why is regular follow-up important in patients with AF?
Follow-up ensures optimal symptom management, monitors anticoagulation effectiveness, and addresses any complications.
