Epidemiology/Pathophysiology

Question 1

Characterized by an atrial rate:

Answer 1

400-600 beats/min

Question 2

Ventricular Response rate:

Answer 2

120-180 beats/min

Question 3

Recurrent

Answer 3

2 or more episodes

Question 4

Paroxysmal

Answer 4

terminates spontaneously or with intervention within 7 days of onset, episodes may recur with variable frequency

Question 5

Persistent

Answer 5

sustained beyond 7 days

Question 6

Longstanding Persistent

Answer 6

Continuous AF of > 12 months duration

Question 7

Permanent AF

Answer 7

Term used when there has been a joint decision by the patient and clinician to cease further attempts to restore and/or maintain sinus rhythm (just going to try to control ventricular rate)

Question 8

Nonvalvular AF

Answer 8

AF in the absence of rheumatic mitral stenosis, a heart valve, or mitral valve repair (important in stroke prevention of afib patients)

Question 9

Reversible Risk Factors

Answer 9

• Alcohol intake
• surgery
• Heart Damage: MI, pericarditis, myocarditis
• PE
• Hyperthyroidism

Question 10

Irreversible Causes

Answer 10

• Valvular heart disease (most often mitral valve disease; sometimes reversed with valve replacement)
• HF, CAD
• HTN (esp wen LV hypertrophy is present)

Question 11

Factors that decrease success of treating AF

Answer 11

• Presence of coronary artery disease
• Heart Failure
• Age > 75 years
• Prior stroke/TIA

Question 12

Subjective Signs/Symptoms of AF

Answer 12

• Rapid heart rate
• Palpitations
• SOB
• Fatigue
• Syncope
• Peripheral edema
• Chest pain
• Anxiety
• dizziness

Question 13

Objective Signs in AF

Answer 13

• ECG changes: dropped P wave, irregularly irregular rhythm

- Fast ventricular rate (120+ not uncommon)

Question 14

Treatment goals

Answer 14

• prevention of the disease-related complications

- control of symptoms

Question 15

Three Treatment Strategies

Answer 15

• Rate Control
• Rhythm Control
• Prevention of Stroke