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Cardiology > Atrial Fibrillation AF > Flashcards

Atrial Fibrillation AF Flashcards

1
Q

What is atrial fibrillation (AF)?

A

AF is a supraventricular arrhythmia characterised by an irregularly irregular rhythm and the absence of distinct P waves on an ECG.

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2
Q

What are the common types of AF?

A

Paroxysmal (self-terminates within 7 days), persistent (lasts >7 days or requires intervention), and permanent (accepted as the long-term rhythm).

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3
Q

What are the main symptoms of AF?

A

Symptoms include palpitations, dizziness, breathlessness, fatigue, and, in severe cases, syncope or angina.

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4
Q

What are the common causes of AF?

A

Causes include hypertension, coronary artery disease, valvular heart disease, heart failure, hyperthyroidism, and excessive alcohol consumption.

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5
Q

What is the pathophysiology of AF?

A

Disorganised atrial electrical activity leads to ineffective atrial contraction, causing stasis of blood in the atria and an irregular ventricular response.

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6
Q

What are the risk factors for developing AF?

A

Age, hypertension, obesity, diabetes, heart disease, excessive alcohol intake, and sleep apnoea.

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7
Q

How is AF diagnosed?

A

AF is diagnosed using ECG, which shows an irregularly irregular rhythm and absence of P waves, replaced by fibrillatory waves.

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8
Q

What are the complications of untreated AF?

A

Complications include stroke, thromboembolism, heart failure, and reduced quality of life.

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9
Q

What is the role of echocardiography in AF?

A

Echocardiography assesses atrial size, ventricular function, valvular disease, and the presence of thrombi.

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10
Q

What is the CHA₂DS₂-VASc score?

A

It estimates stroke risk in patients with AF and guides decisions about anticoagulation therapy.

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11
Q

What are the components of the CHA₂DS₂-VASc score?

A

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).

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12
Q

What is the HAS-BLED score?

A

It assesses bleeding risk in patients with AF who are being considered for anticoagulation.

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13
Q

What are the goals of AF management?

A

To control symptoms, prevent thromboembolism, and manage underlying conditions.

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14
Q

What are the two main strategies for managing AF?

A

Rate control and rhythm control.

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15
Q

What medications are used for rate control in AF?

A

Beta-blockers (e.g., bisoprolol), calcium channel blockers (e.g., diltiazem), or digoxin.

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16
Q

What medications are used for rhythm control in AF?

A

Antiarrhythmics like amiodarone or flecainide are used to restore and maintain sinus rhythm.

17
Q

What is electrical cardioversion, and when is it used?

A

Electrical cardioversion is a procedure using synchronised shocks to restore sinus rhythm in symptomatic or persistent AF.

18
Q

When is anticoagulation recommended in AF?

A

Anticoagulation is recommended for patients with a CHA₂DS₂-VASc score of ≥1 in men or ≥2 in women.

19
Q

What are the common anticoagulants used in AF?

A

Direct oral anticoagulants (DOACs) like apixaban and rivaroxaban or vitamin K antagonists like warfarin.

20
Q

What are the indications for catheter ablation in AF?

A

Symptomatic AF refractory to medical therapy or as a first-line option in selected patients.

21
Q

What lifestyle changes are recommended for patients with AF?

A

Weight management, reducing alcohol intake, smoking cessation, managing hypertension, and regular physical activity.

22
Q

What is the role of left atrial appendage occlusion in AF?

A

It is a non-pharmacological option to reduce stroke risk in patients who cannot tolerate anticoagulation.

23
Q

What is lone AF?

A

Lone AF refers to AF occurring in younger patients without identifiable risk factors or structural heart disease.

24
Q

How does AF increase stroke risk?

A

AF causes stasis of blood in the atria, particularly in the left atrial appendage, leading to thrombus formation and potential embolism.

25
Q

Why is regular follow-up important in patients with AF?

A

Follow-up ensures optimal symptom management, monitors anticoagulation effectiveness, and addresses any complications.

Cardiology (17 decks)

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