Week 3 - Arrhythmias Flashcards
What is the most common arrhythmia
AF
What is the prevalence of AF
Increases with age.
10% ≥ 70 years; 23% ≥ 80 years
What causes AF
Supraventricular tachyarrhythmia
– Uncoordinated atrial contraction
– Irregular and frequently fast ventricular rate
What is the classification for AF
First diagnosis - Paroxysmal AF - Persistent AF - Long standing persistent AF - Permanent AF
What are symptoms of AF
Palpitations, Dyspnoea, Chest tightness, Fatigue / lethargy, Sleeping disturbance, Psychological effects
Aetiological factors which cause AF
Aging (structural remodelling), Heart failure • Hypertension and Diabetes mellitus • Valvular heart disease (esp. mitral) • Coronary artery disease (atrial ischaemia) • Alcohol excess • Hyperthyroidism (trigger) • Obesity and sleep apnoea • Autonomic activation
What is the diagnostic work up of AF
What investigations would you do
12-lead ECG • BP • Bloods - FBC, U&E, LFT, TFT, Coag • Echocardiogram • Holter monitoring
– Symptom / Rhythm correlation
– AF burden
– Ventricular rate control
How does AF increase risk of stroke?
Blood pools in the atria
Blood clot forms
Whole or part of the clot breaks off
Bloood clot travels to the brain and blocks a cerebral artery causing stroke
What is the drug of choice for AF when no structural heart disease
Flecainide
What is the best drug for AF with structural changes
Amiodarone
Heart rate control drugs examples
beta blockers
Verapamil
Digoxin
What is the score name for stroke risk in AF
CHA DS- VASc score
What is bradycardia
Lower than 60 bpm
What can cause bradycardia
Congenital
Acquired
Degenerative - Ischaemic heart disease - Drugs - Electrolye/metabolic - Infection (eg endocarditis) - Iatrogenic (ablation, cardiac surgery) - Infiltrative diseases (eg sarcoid,
amyloid) - Neuromuscular diseases (eg
myotonic dystrophy)
Which artery supplies the AV node
The right coronary
What symptoms does bradycardia present with
Asymptomatic
Dizziness
Breathlessness
Syncope
Falls
Exercise intolerance
Difficulty concentrating
Fatigue
Tachycardia-bradycardia syndrome
Pacemaker for fast heart rate
Drugs for slow heart rate (beta blockers)
Anticoagulation for strokes
Type 1 AV block
First Degree – PR interval is prolonged but all impulses are
conducted to the Ventricles
Second degree AV block
Second Degree – Some (but not all) impulses are conducted to the ventricles
Third degree AV block
Third Degree – No impulses are conducted to the ventricles
Type 1 second degree hear block is called?
Wenckeback
In Mobitz Ii
P to QRS interval is normal
Sudden p wave not followed by QRS - `Need pacemaker
2:1 AV block
For ever 2 P waves there is only 1 QRS
How do people with tachycardia present
Asymptomatic
SOB
Palpitations
Pre-syncope/ light headed
Chest pain
LOC
Cardiac arrest
