Atrial Fibrillation (AF/AFib) Flashcards
What is AF?
AF is characterised by:
- Irregularly irregular pulse
- Rapid heart rate
- ECG changes
- The most common tachyarrhythmia
What are the causes of AF?
The causes of AF include:
- Idiopathic
- Ischaemic heart disease
- Heart failure
- Valve disease: mitral stenosis and mitral regurg
- Hypertension
- Hyperthyroidism
- Alcohol induced
- Familial
What are the signs and symptoms of AF?
The signs and symptoms of AF include:
- Palpitations
- Dyspnoea
- Syncope
- Exercise intolerance
- Fatigue
- Heart failure
- Irregularly irregular pulse
How do we investigate AF?
Investigations into AF include:
- 12 lead ECG
- Ambulatory ECG device
- ECHO
- TFTs
- CXR
How do we treat AF?
Treatment of AF includes:
Conservative
patient education and management of cardiovascular risk factors, e.g. smoking cessation and decreasing alcohol intake
Medical
treat underlying cause and:
- Restore rate: beta-blocker, calcium antagonist, digoxin, amiodarone
- Restore rhythm: beta-blocker, cardioversion, amiodarone.
- Anticoagulant: e.g. warfarin, apixaba
What are the complications of AF?
The complications of AF include:
- Stroke
- Heart failure
- Sudden death
What is the pathophysiology of AF?
The pathophysiology of AF:
Atrial ectopic beats lead to dysfunction of the cardiac electrical signalling pathway.
Atria no longer contract in a coordinated manner but fibrillate and contract irregularly.
Due to the irregular contractions, the atria fail to empty adequately.
This may result in stagnant blood within the atrial, increasing the risk of clot formation and therefore stroke.
How would you diagnose AF on an ECG?
Diagnosis of AF on an ECG:
Irregularly irregular QRS intervals
Narrow QRS complexes*
Absent P waves
Undulating baseline
* QRS may be broad if there is an existing ventricular conduction problem such as LBBB
