Atrial Fibrillation + Flutter

Question 1

Which drugs are used in rate control of AF

Answer 1

B-blockers
Diltiazem
Digoxin can be used first line if the patient is sedentary

Question 2

Which drugs are used in rhythm control of AF?

Answer 2

If not controlled with rate
B-blockers
Amiodarone, flecaininde, dronedarone

Question 3

What are the features of the CHADS2VASc score?

Answer 3

Cardiac Failure (1)
HTN (1)
Age 65-74 (1) >75 (2)
DM (1)
Stroke, TIA or VTE (2), 
Female (1)
Vasc: MI, stents (1)
Men with a score of1 and women with a score of 2 should be considered for anti-coagulation

Question 4

When considering putting an AF patient on anti-coagulants, how do we assess their risk of bleeding?

Answer 4

ORBIT

Question 5

What are the variables in the ORBIT score?

Answer 5

Haemoglobin
Age
Anti-platelets
Bleeding episode
eGFR

Question 6

What is the management of acute AF with HD instability?

Answer 6

Electrical cardioversion

Question 7

What is the management of acute AF with onset less than 48 hours?

Answer 7

Rate control or electrical cardioversion

Question 8

What is the management of acute AF with uncertain onset or onset more than 48 hours?

Answer 8

Rate control

Question 9

Following sucessful DC cardioversion, what action is needed for patients with a high CHADSVasc score?

Answer 9

Continue lifelong anticoagulation