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Atrial Fibrillation (causes (ischaemic heart disease, hypertension,…
Atrial Fibrillation
causes
ischaemic heart disease
hypertension
valvular heart disease
hyperthyroidism
complications
CVA
heart failure
tachycardia-induced cardiomyopathy and critical cardiac ischaemia
reduced quality of life
management
rate control with calcium channel-blocker or beta-blocker
referral for cardioversion
new onset AF
if AF has reversible cause eg LRTI
heart failure
atrial flutter ? ablation to restore sinus rhythm
anyone who needs further assessment
bloods
presentation
SOB, palpitations, chest discomfort, syncope/dizziness, reduced exercise tolerance, malaise, polyuria, CVA, TIA, heart frailure
absence of irregular HR makes AF unlikely but its presence is not diagnosis for AF
suspect paroxysmal AF if symptoms episodic and last less than 48 hours
ECG
with AF will show no P waves, a chaotic baseline, irregular ventricular rate
ADMIT
SOB, chest pain, syncope
lifestyle advice
stop smoking, reduce weight, reduce alcohol
AF is an arrhythmia. Resulting from irregular, disorganised electrical activity in the atria leading to irregular ventricular rhythm. Averaging between 160-180 bpm
Assess CVA risk using CHA2DS2VASc assessment
Assess for benefits of anti-coagulation
arrange follow up within one week