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4th Year > CCC - AF > Flashcards

CCC - AF Flashcards

1
Q

How common is AF?

A

10% people over 65yrs

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2
Q

What is paroxysmal AF?

A

Occurs sometimes, stops by itself

Can last seconds - days

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3
Q

What is persistent AF?

A

AF that does not stop by itself

Requires medications or cardioversion

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4
Q

What is permanent AF?

A

AF that cannot be corrected

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5
Q

What is the pathophysiology of AF?

A

Irregular atrial rhythm causes by rapidly firing cells at the junction of the pulmonary vein in the LA

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6
Q

How does AF cause irregular ventricular rhythm?

A

AV node receives more impulses than it can conduct -> irregular rhythm
Untreated rhythm often 160-180bpm

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7
Q

What are common causes of AF? (4)

A

IHD
HTN
Valvular disease
Hyperthyroidism

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8
Q

What are some less common causes of AF?

A 
PE
Caffeine
Post-operation
Low K+ or Mg2+
Lung cancer
Atrial myxoma
Endocarditis
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9
Q

What are some features of AF?

A

Breathless
Palpitations
Syncope
Fatigue

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10
Q

What are some signs of AF?

A

Irregularly irregular pulse

Apical pulse is greater than radial pulse

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11
Q

What are some complications of AF?

A

Stroke
Heart failure
Cardiomyopathy
Reduced QoL

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12
Q

What will an ECG show in AF?

A

Absent P-waves
Irregular QRS and PR intervals
Choatic baseline
Tachycardia

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13
Q

What blood tests should you perform in AF? (7)

A 
U+E
TFT
Cardiac enzymes
BNP
Calcium
Magnesium
Glucose
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14
Q

What might an echo show win AF?

A

Enlarged LA

Mitral valve disease

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15
Q

What tests do you need in paroxysmal AF?

A

24hr ambulatory ECG

Event recorder if episodes >24hrs apart

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16
Q

When do you need an echo in AF?

A

If considering cardioversion

If there is a high risk of stuctural/functional heart disease

17
Q

What is in CHA2DS2-VASc score?

A 
CHF
HTN
Age >75yrs (2)
DM
Stroke/TIA (2)
Valvular disease
Age 65-74yrs
Female
18
Q

What does the CHA2D2-VASc score mean?

A

0-2 = Aspirin

>1 in men or >2 in women = Warfarin

19
Q

What is in HAS-BLED?

A 
HTN
Abnormal Liver or Renal function
Stroke
Bleeding disorder
Labile INR
Elderly >65yrs
Drugs (eg. NSAIDs) or Alcohol use
20
Q

What are the options for anticoagulation in AF?

A 
Warfarin
Apixaban
Rivaroxaban
Dabigatran
Etexilate
21
Q

When to offer anticoagulation in AF?

A

CHADS-VASc
>1 in men
>2 in women

22
Q

What is the first line treatment of AF?

A

Rate control

23
Q

What medications are used for rate control in AF?

A

Beta-blocker eg. bisoprolol

Diltiazem

24
Q

Who would you not consider rate control in immediately for AF? (3)

A

AF with reversible cause (eg. hyperthyroidism)
Heart failure secondary to AF
New-onset AF

25
Q

Who would you consider rhythm control in for AF?

A

If rate control has not been effective

26
Q

When would you consider cardioversion?

A

If AF has persisted >48hrs = electrical cardioversion

May need Amiodarone for 4wks prior to up to 12m after cardioversion

27
Q

What are pharmacological cardioversion agents?

A

Amiodarone

Sotalol

28
Q

When would you use DC shock in AF?

A

If they are harm-dynamically unstable

29
Q

When would you use chemical cardioversion in AF?

A

AF less than 2 days

30
Q

When you use electrical cardioversion in AF?

A

AF longer than 2 days

31
Q

What are the drugs of long-term rhythm control in AF?

A

Beta-blocker
Dronedarone if CVS risk factors
Amiodarone if LV impairment or HF

32
Q

When would you consider left atrial ablation in AF?

A

If drug treatment has failed to control symptoms

33
Q

When would you consider a pacemaker + AV node ablation in AF?

A

Permanent AF

LVDS caused by high ventricular rate

34
Q

What is the acute management of AF?

A

DC shock if in shock
<48hrs = Amiodarone
Heparin if no contraindications

35
Q

By how much does AF increase your stroke risk?

A

5%

36
Q

In what age group is AF the biggest stroke risk factor?

A

80-89yrs

4th Year (15 decks)

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