ATRIAL FIBRILLATION

Classification
Paroxysmal AF - AF that terminate spontaneously or with
intervention in <7 days. recurrant episode may occur.
Persistant AF - AF that fails to terminate within 7 days. Episodes
often require pharmacologic or cardioversion to restore sinus
rhythm.
Long standing AF - AF that lasted >12 months
Permanent AF - Joint decision between patient and clinician not to
pursue rhythm control treatment

Causes

cardiac causes : Myocardial infarction, heart failure, atrial septal

defect, valvular disease, ventricular hypertrophy
No discrete P wave non cardiac causes : hypothermia, COPD, cor pulmonale, pneumonia
irregular baseline , pulmonary embolism, sleep apnea
irregular QRS complexes, rate varying thyroid disorder
between 75 bpm and 190 bpm.
ATRIAL FIBRILLATION

Risk assesment

Stroke risk : CHADVASC score

Bleeding risk : HAS-BLED score > 3 = high risk
ATRIAL FIBRILLATION Rate control

Brief management
Aim <80 bpm during resting, <110bpm during
moderate exercise
Medication ; B blocker, nonhydroperidine CCB :
Diltiazem/verapamil, Digoxin

Rythm control

cardioversion
amiodarone
flecanide
STEMI Rate control

ECG changes
STEMI
causes
STEMI Brief management