Notes in 02_Arrhythmias: Atrial Fibrillation

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Status	Last Update	Fields
Published	02/10/2024	Presentation of {{c2::Atrial Fibrillation}} {{c1::Palpitations}} {{c1::Shortness of breath}} {{c1::Dizziness +/- Syncope (fainting)}} {{c1::Symptoms o…
Published	02/10/2024	A major complication of Atrial Fibrillation is {{c1::cardioembolic stroke}} leading to cerebral vessel occlusion
Published	02/10/2024	Causes of Atrial FibrillationRemembered as {{c1::SMITH}} {{c1::Sepsis}} {{c1::Mitral Valve Pathology (stenosis or regurgitation)}} {{c1::Ischaemic He…
Published	02/10/2024	Investigations done to exclude Thyrotoxicosis as a cause of Atrial Fibrillation include:{{c1::Thyroid function tests (TFTs)}}
Published	02/10/2024	Investigations done to exclude Sepsis as a cause of Atrial Fibrillation include:{{c1::Signs such as tachypnoea, low urine output, and fever}}{{c1::Blo…
Published	02/10/2024	In Atrial Fibrillation, ensure that the {{c1::blood pressure}} is control to reduce risk of stroke
Published	02/10/2024	Signs of {{c2::Atrial Fibrillation}} on ECG{{c1::Tachyarrhythmia}}{{c1::Absent P waves}}{{c1::Irregularly irregular rhythm}}
Published	02/10/2024	This ECG shows:{{c1::Atrial Fibrillation}}
Published	02/10/2024	Score to Assess Initiation of Anticoagulation in Atrial Fibrillation{{c1::CHA2DS2-VASc}}
Published	02/10/2024	CHA2DS2-VAScA higher score indicates an increase in the likelihood of developing a stroke C – {{c1::Congestive heart failure}} H – {{c1::Hyp…
Published	02/10/2024	CHA2DS2-VAScScore 0: {{c1::no anticoagulation}} 1: {{c1::consider anticoagulation in males (not females because female = 1 point)}} ≥2: {{c1::offer a…
Published	02/10/2024	Score to Assess The Risk of Bleeding in Patients with Atrial Fibrillation on Anticoagulation{{c1::ORBIT}}
Published	02/10/2024	ORBITThis is used to assess the risk of major bleeding in patients with atrial fibrillation that use anticoagulation O — {{c1::Old (≥75)}} R — {{c1::R…
Published	02/10/2024	The treatment of Atrial Fibrillation involves three principles: {{c1::Rate control}} {{c1::Rhythm control}} {{c1::Stroke control}}
Published	02/10/2024	Purpose of Rate Control in Atrial Fibrillation{{c1::The aim is to reduce heart rate so that the diastolic time is increased and the ventricles ca…
Published	02/10/2024	Contraindications of Rate Control in Atrial Fibrillation {{c1::Reversible cause of AF}} {{c1::New onset (<48 hours)}} {{c1::Causing heart failure}}…
Published	02/10/2024	Pharmacological Agents for Rate Control of Atrial Fibrillation{{c1::Beta blocker (e.g. Atenolol)}}{{c1::Calcium-channel blocker (e.g. Diltia…
Published	02/10/2024	First-line Treatment for Rate Control and Long Term Rhythm Control of Atrial Fibrillation{{c1::Beta blockers (e.g. Atenolol)}}
Published	02/10/2024	Second-line Treatment for Rate Control of Atrial Fibrillation{{c1::Calcium-channel blocker (e.g. Diltiazem)}}
Published	02/10/2024	{{c1::Calcium-channel blocker (e.g. Diltiazem)}} is used as second-line rate control for Atrial Fibrillation, but it is avoided in patients who h…
Published	02/10/2024	{{c1::Digoxin}} is a pharmacological agent used for rate control of Atrial Fibrillation in {{c2::sedentary}} patients and requires monitoring for toxi…
Published	02/10/2024	Indications of Rhythm Control in Atrial Fibrillation {{c1::Reversible cause of AF}} {{c1::New onset (<48 hours)}} {{c1::Causing heart failure}} {{c…
Published	02/10/2024	Short-Term Options for Rhythm Control of Atrial Fibrillation{{c1::Pharmacological cardioversion (e.g. Flecainide, Amiodarone)}}{{c1::Electrical c…
Published	02/10/2024	{{c1::Flecainide}} is used for short-term rhythm control of Atrial Fibrillation and is avoided if patients have {{c2::structural heart disease}}
Published	02/10/2024	Long-Term Options for Rhythm Control of Atrial Fibrillation{{c1::Beta blocker (e.g. Atenolol)}}{{c1::Dronedarone (if successful cardioversion)}}{…
Published	02/10/2024	{{c1::Amiodarone}} is used for short-term and long-term rhythm control of Atrial Fibrillation if there is evidence of {{c2::structural heart disease (…
Published	02/10/2024	Pharmacological Options for Anticoagulation in Atrial FibrillationFirst-line: {{c1::Direct Oral Anticoagulants (DOACs) (e.g. Apixaban, Dabigatran…
Published	02/10/2024	WITHOUT Anticoagulation, patients with Atrial Fibrillation have around a {{c1::5}}% risk of stroke each year (depending on CHADSVASc&nb…
Published	02/10/2024	WITH Anticoagulation, patients with Atrial Fibrillation have around a {{c1::1-2}}% risk of stroke each year (depending on CHADSVASc&nbs…
Published	02/10/2024	Anticoagulation reduces the risk of Stroke in Atrial Fibrillation by about {{c1::2/3}}
Published	02/10/2024	Name: {{c2::Warfarin}}Mechanism of Action: {{c1::Vitamin K antagonist}}Function: {{c1::Prolongs prothrombin time which is the time it takes …
Published	02/10/2024	Indications of Usage of Warfarin over Direct Oral Anticoagulants (DOACs) {{c1::Mechanical valve}} {{c1::Antiphospholipid syndrome}} {{c1::High risk of…
Published	02/10/2024	What is International Normalized Ratio (INR)?{{c1::The INR is a calculation of how a patient’s prothrombin time compares with the …
Published	02/10/2024	An INR of {{c1::1}} means{{c2::Normal prothrombin time (i.e. normal clotting time)}}
Published	02/10/2024	An INR of {{c1::2}} means{{c2::Takes twice as long to form a blood clot}}
Published	02/10/2024	The target INR for Atrial Fibrillation is {{c1::2 — 3}}
Published	02/10/2024	Factors that Affect Warfarin {{c1::Cytochrome P450}} {{c1::Vitamin K rich foods (leafy green vegetables)}} {{c1::Cranberry juice (affects Cytochrome P…
Published	02/10/2024	If the patient with Atrial Fibrillation is {{c2::Haemodynamically unstable}} then offer:{{c1::Electrical cardioversion (shock the heart into sinus rhy…
Published	02/10/2024	If the onset of Atrial Fibrillation was {{c2::<48 hrs}} and the patient is {{c2::Haemodynamically stable}} then offer:{{c1::Cardioversion: Pharmaco…
Published	02/10/2024	If the onset of Atrial Fibrillation was {{c2::>48 hrs}} then offer {{c1::Anticoagulation for at least 3 weeks}} {{c1::Transthoracic echocardio…
Published	02/10/2024	If the type of Atrial Fibrillation is {{c2::Chronic}} or {{c2::Permanent}} then offer {{c1::Rate control (e.g. beta blocker, calcium channel bloc…
Published	02/10/2024	If the type of Atrial Fibrillation is {{c2::Paroxysmal/Episodic}} then offer {{c1::Rate control with beta blockers (e.g. Atenolol)}} {{c1::Consid…
Published	02/10/2024	Assess the risk of Stroke in Atrial Fibrillation with {{c1::CHADVASC}} and offer DOAC accordingly if the score {{c2::≥2}} in females or {{c2::≥1}} in …
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