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ATRIAL FIBRILLATION (AF), RATE CONTROL FIRST LINE FOR MOST PEOPLE WITH AF…

- - - - Pulmonary embolism
        
        Diabetes Mellitus
        
        Electrolyte depletion
        
        Thyrotoxicosis
- - - - Obesity
        
        Smoking
        
        Medication exposure (thyroxine/bronchodilators
- - - - CARDIAC ISCHAEMIA
      - ASSOCIATED WITH REDUCED QUALITY OF LIFE
      - MORTALITY ASSOCIATED WITH CARDIOVASCULAR DISEASE
- - - - Sinus tachycardia- sinus rhythm with > 100 beats
        
        Sinus rhythm with premature atrial or ventricular contractions
        
        Multifocal atrial tachycardia
        
        WOLF-PARKINSON-WHITE SYNDROME
- - - - IN ABSENCE OF HAEMODYNAMIC INSTABILITY SYMPTOMS (RAPID PULSE, LOW BP, LOSS OF CONCIOUSNESS, SYNCOPE, CHEST PAIN, DIZZINESS, INCREASING BREATHLESSNESS), CONSIDER MANAGING IN PRIMARY CARE
        
        ADMIT OR REFER WITHURGENCY IF SIGNS SUGGESTIVE OF STROKE, HEART FAILURE, PULMONARY EMBOLISM, PNEUMONIA OR THYROTOXICOSOS
        
        WHERE UNDERLYING CAUSE FOR AF IDENTIFIED, MANAGE WHERE POSSIBLE OR REFER AS APPROPRIATE USING CLINICAL JUDGEMENT TO DETERMINE URGENCY
- - - - UNCONTROLLED HYPERTENSION
        
        POOR CONTROL OF INR
        
        HARMFUL ALCOHOL CONSUMPTION
        
        REVERSIBLE CAUSES OF ANAEMIA
        
        CONCURRENT MEDICATION INCLUDING ANTIPLATELETS, SELECTIVE SEROTONIN REUPTAKE INHIBITORS & NSAIDs
- - - - APIXABAN/DABIGATRAN/EDOXABAN/RIVAROXABAN
        
        IF DOACS CONTRAINDICATED, OFFER VIT K ANTAGONIST
        
        FOR ADULTS ALREADY TAKING VIT K & STABLE, CONTINUE WITH CURRENT MEDICATION& DISCUSS OPTION OF SWITCHING AT NEXT ROUTINE APPT
- - - - Explain when to seek further/immediate medical advice
        
        Provide info on stroke awareness/prevention
        
        No flying restrictions if AF stable
        
        Patient's responsibility to inform DVLA of any condition that may affect their ability to drive (ADVISE PT OF THIS)
        
        Advise to check with insurer if covered
        
        GIVE INFO ON SUPPORT GROUPS (Signpost to Atrial Fibrillation Association)