Week 13: Atrial Fibrillation (AF)

Question 1

What is AF? (3)

Answer 1

Irregular, disorganised electrical activity in the atria.

Rapid firing impulses -> Disorganised atrial depolarisation and ineffective atrial contractions.

AV nodes receive more electrical impulses than it can conduct causing irregular ventricular rhythm.

Question 2

What is the ventricular rate of untreated AF? (2)

Answer 2

160-180 bpm
Slower in elderly.

Question 3

What can irregular atrial contractions result to? (1)

Answer 3

Blood stasis clot formation

Question 4

What is paroxysmal AF? (3)

Answer 4

Episodes lasting > 30 sec but < 7 days.

Often < 48 hrs

Self-limiting + recurrent

Question 5

What is persistent AF? (3)

Answer 5

Episodes lasting > 7 days

or < 7 days but needs cardioversion

Spontaneous termination of arrhythmia is unlikely to occur.

Question 6

What is permanent AF? (2)

Answer 6

Fails to terminate after cardioversion.
Terminated but relapse within 24 hrs.

Question 7

What is longstanding/permanent AF? (2)

Answer 7

> 1 yr
Cardioversion has not been indicated or attempted.

Question 8

What are the common causes of AF? (5)

Answer 8

Hypertension
Ischaemic Heart Disease
Myocardial Infarction
Valvular Heart Disease
Hyperthyroidism

Question 9

Give e.g. of medications that can cause AF. (2)

Answer 9

Thyroxine
Bronchodilators (Salbutamol)

Question 10

What lifestyle factors can cause AF? (4)

Answer 10

Excessive caffeine
Alcohol abuse
Obesity
Smoking

Question 11

What is the common prevalence rate of AF? (1)

Answer 11

Increases with age (40 yrs = 1/4 lifetime risk of AF)

Question 12

What are the potential complications for AF? (6)

Answer 12

Stroke/Thromboembolism risk
HF
Tachycardia-induced cardiomyopathy
Critical cardiac ischaemia
Reduced QofL
Increased mortality rate.

Question 13

What are the common symptoms of AF? (

Answer 13

Breathlessness
Palpitations
Chest Discomfort
Syncope
Dizziness
Stroke/TIA
Reduced exercise tolerance
Malaise