Atrial Fibrillation Basics Flashcards

1
Q

What is atrial fibrillation?

A

Cardiac arrhythmia
Characterised by disorganised electrical activity within the atria
Results in ineffective atrial contraction and irregular ventricular contraction

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2
Q

What are the types of atrial fibrillation?

A

Paroxysmal - terminate within 7 days
Persistent - episodes last longer than 7 days
Permanent - decision not to treat

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3
Q

What is AF a type of?

A

Supraventricular cardiac arrhythmia - originates above the ventricles

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4
Q

Where does AF originate from?

A

Left atrial myocytes and extends around the pulmonary vein

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5
Q

What does the chaotic electrical activity cause?

A

Intermittently conducted through AVN - gives rise to irregularly irregular ventricular rate

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6
Q

What is the main cause of AF?

A

Triggers typically cause the atria to stretch - changes their electrical properties

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7
Q

What are cardiac causes of AF?

A

Hypertension
Ischaemic heart disease
Heart failure with reduced ejection fraction
Structural pathology
Congenital heart disease
Atrial or ventricular dilatation / hypertrophy
Pre-excitation syndromes
Sick sinus syndrome
Inflammatory conditions
Infiltrative conditions

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8
Q

What are non-cardiac causes of AF?

A

Acute infection
Electrolyte imbalance
Pulmonary embolism
Thyrotoxicosis or hypothyroidism
Diabetes

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9
Q

What are the risk factors for AF?

A

Gender
Caucasian ethnicity
Age
Alcohol
Smoking
Obesity
Co-morbidities

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10
Q

What are typical symptoms of AF?

A

Breathlessness
Chest discomfort
Palpitations
Light headedness
Reduced exercise tolerance
Syncope

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11
Q

What do you find on clinical examinations?

A

Irregularly irregular pulse
Radial-apical deficit; each ventricular contraction may not be sufficiently strong enough to transmit a pulse to radial artery
Raised jugular venous pressure
Added heart sound
Crackles on chest auscultation
Ankle swelling

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12
Q

What do you find on an ECG?

A

Irregularly irregular rhythm
Absent p wave

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13
Q

What other examinations do you do?

A

FBC - to see for any causes
U + E - to see for any causes
LFT - establish baseline hepatic function before giving anticoagulants
TFT - assess for thyroid dysfunction
CRP - to see for any causes
Clotting screening
NT-proBNP - underlying heart failure

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