Atrial fibrillation

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Atrial fibrillation 作者: Mind Map: Atrial fibrillation

1. Causes

1.1. Heart valve disease

1.2. CAD

1.3. HTN

1.4. PE

1.5. Cardiothoracic surgery

1.6. Heart Failure

1.7. Congenital Heart Disease

1.8. Excessive alcohol or caffiene intake

1.9. Hyperthyroidism

2. What is it?

2.1. Irregular beating of the atria

2.1.1. EKG showing afib

2.1.1.1. no P wave, wavy baseline instead

2.2. Rapid heart rate

2.2.1. 110 to 180 beats per minute

3. Symptoms

3.1. Palpitations

3.1.1. may give feeling of need to cough

3.2. SOB

3.2.1. increases with activity

3.3. presyncope, syncope, or dizziness

3.4. chest pain/pressure

3.5. weakness/fatigue

4. Treatment

4.1. Rate Control

4.1.1. Betablockers

4.1.1.1. metoprolol or carvedilol

4.1.2. calciumchannel blockers

4.1.2.1. diltiazem

4.1.3. Cardiac glycoside

4.1.3.1. Digoxin

4.1.4. Permanent Pacemaker

4.2. Anticoagulation Management

4.2.1. CHADS2 score of 2 or more

4.2.1.1. Pradaxa or Coumadin

4.3. Rhythm Contorl

4.3.1. Antiarrhythmia medication

4.3.1.1. Tikosyn

4.3.1.1.1. must be hospitalized for initiation

4.3.1.2. Sotalol

4.3.1.3. Amiodarone

4.3.1.3.1. side effects

4.3.1.4. Flecainide

4.3.1.5. Propafenone

4.3.2. Ablation

4.3.2.1. Targeted/focal

4.3.2.1.1. return to NSR if successful

4.3.2.2. AV node

4.3.2.2.1. often symptom control, not rhythm control

4.3.2.2.2. destroys ability of AV node to send electrical impulses

4.3.3. MAZE procedure

4.3.3.1. incisions made on atria

4.3.3.1.1. Scar tissue forms

4.3.4. Cardioversion

4.3.4.1. return to NSR is successful

4.3.4.2. starting dose 100 to 120 Joules

5. Diagnosis

5.1. Cardiac monitoring

5.1.1. Holter monitor

5.1.2. portable event monitor

5.2. EKG

5.3. Electrophysiologist/cardiologist consult

6. Complications

6.1. Heart failure

6.1.1. with prolonged lack of rhythm/rate control

6.2. Clot

6.2.1. MI

6.2.2. Stroke