Cardiology - Atrial fibrillation

Question 1

What is atrial fibrillation?

Answer 1

Irregular atrial contraction, caused by chaotic impulses

Question 2

What are the 3 hallmark ECG features of atrial fibrillation?

Answer 2

irregular rhythm
absence of P waves
irregular baseline

Question 3

What is paroxysmal AF?

Answer 3

recurrent episodes that end within 7 days

Question 4

What is persistent l AF?

Answer 4

AF that lasts more than a week

Question 5

What is permanent AF?

Answer 5

the rhythm cannot be restored

Question 6

What are the five common cardiac causes of AF?

Answer 6

hypertension
ischaemic heart disease
valvular disease
myocardial infarction
cardiomyopathy

Question 7

What is a major complication of AF?

Answer 7

thrombus formation within the atria

Question 8

What are 3 key signs of atrial fibrillation?

Answer 8

Irregular pulse
absent ‘a’ wave on JVP
hypotension

Question 9

What are 3 features of heart failure?

Answer 9

Bibasal cracks
raised JVP
peripheral oedema

Question 10

What are 4 causes of an irregular pulse?

Answer 10

atrial fibrillation
premature beats
atrial flutter with variable block
atrial tachyarrhythmias

Question 11

How is atrial fibrillation characterised on an ECG?

Answer 11

irregular rhythm
absent P waves
fibrillating baseline

Question 12

How should infection be treated if identified as the underlying cause of AF?

Answer 12

Antibiotics

Question 13

How should myocardial infarction be treated if identified as the underlying cause of AF?

Answer 13

antiplatelets

Question 14

What are 3 rate controlling medication options for patients with AF?

Answer 14

Beta blockers
Rate-limiting calcium channel blockers
Digoxin

Question 15

What cardioversion medication is used to restore and/or maintain normal sinus rhythm?

Answer 15

amiodarone
flecainide
beta blockers

Question 16

What should initially be checked for an AF patient?

Answer 16

haemodynamic instability - defibrillator

haemodynamic stability - check anticoagulation status

Question 17

What should be done after checking anticoagulation status of patients with stable AF?

Answer 17

if therapeutic - cardioversion

if none - initiate anticoagulation drugs

Question 18

After patients have been given anticoagulants, what determines the type of cardioversion?

Answer 18

If patients have had AF over 48 hours then there is risk of thrombus so cardioversion needs to be given over weeks
If patients have had AF under 48 hours then there is less of a risk