Chronic Atrial Fibrillation Treatment || 100% Errorless
Answers.
Risk factors for afib? (6) correct answers Uncontrolled HTN
Heart failure
DM
Hyperthyroidism
MI
Advanced age
What is used to diagnose Afib? correct answers EKG
Afib is often (symptomatic/asymptomatic)
What are some symptoms? (3) correct answers asymptomatic
palpiations
chest discomfort
light headedness
Describe the following:
Acute AF
Paroxysmal AF
Persistent AF
Longstanding Persistent AF
Permanent AF
Recurrent correct answers onset within 48 hours
termination within 7 days
AF >7 days
continuous AF >1 year
no further attempts to restore NSR
>/= 2 episodes
What are the consequences of AF? (3) correct answers Systemic embolism
Cardiomyopathy
Hemodynamic dysfunction
Goals of therapy (3) correct answers Primary prevention (stop before it starts)
Prevent: stroke, tachycardia-induced cardiomyopathy, and symptoms
Improve survival
What medications can be used for primary prevention? (4) correct answers omega-3
statins
gemfibrozil
ACE inhibitors
, Gemfibrozil might be helpful in the (short/long) term but not the (short/long) term correct
answers short; long
Is there a proven prevention strategy? correct answers No
____: regulation of ventricular rate
____: restoration and maintenance of normal sinus rhythm (NSR) correct answers Rate control
Rhythm control
In trials is rate or rhythm control proven to be better? correct answers No - similar outcomes with
both of these strategies
In what instance would we choose rhythm control first? (4) correct answers First episode or early
in course of disease
Highly symptomatic
AF caused by reversible cause
High chance of maintaining SR
In what instance would we choose rate control first? (4) correct answers Asymptomatic
Failed (or likely to fail) rhythm control
Adverse effects
Older patients
Which two agents have effects consistent with all four classes? correct answers amiodarone
dronedarone
Which two drugs need to be dosed for renal dysfunction? correct answers dofetilide
sotolol
What are three main DDIs with amiodarone and what do we do for these drug interactions?
correct answers Warfarin: decrease warfarin dose by 50%
Digoxin: decrease digoxin dose by 50%
Simvastatin: limit to 20 mg/day
What are some monitoring parameters with amiodarone? (5) correct answers BP, HR, EKG
rhythm
Baseline PFTs
TSH
Ophthalmic exams
Why do we need baseline PFTs?
Why do we need ophthalmic exams?
Why do we check TSH? correct answers Pulmonary fibrosis
Answers.
Risk factors for afib? (6) correct answers Uncontrolled HTN
Heart failure
DM
Hyperthyroidism
MI
Advanced age
What is used to diagnose Afib? correct answers EKG
Afib is often (symptomatic/asymptomatic)
What are some symptoms? (3) correct answers asymptomatic
palpiations
chest discomfort
light headedness
Describe the following:
Acute AF
Paroxysmal AF
Persistent AF
Longstanding Persistent AF
Permanent AF
Recurrent correct answers onset within 48 hours
termination within 7 days
AF >7 days
continuous AF >1 year
no further attempts to restore NSR
>/= 2 episodes
What are the consequences of AF? (3) correct answers Systemic embolism
Cardiomyopathy
Hemodynamic dysfunction
Goals of therapy (3) correct answers Primary prevention (stop before it starts)
Prevent: stroke, tachycardia-induced cardiomyopathy, and symptoms
Improve survival
What medications can be used for primary prevention? (4) correct answers omega-3
statins
gemfibrozil
ACE inhibitors
, Gemfibrozil might be helpful in the (short/long) term but not the (short/long) term correct
answers short; long
Is there a proven prevention strategy? correct answers No
____: regulation of ventricular rate
____: restoration and maintenance of normal sinus rhythm (NSR) correct answers Rate control
Rhythm control
In trials is rate or rhythm control proven to be better? correct answers No - similar outcomes with
both of these strategies
In what instance would we choose rhythm control first? (4) correct answers First episode or early
in course of disease
Highly symptomatic
AF caused by reversible cause
High chance of maintaining SR
In what instance would we choose rate control first? (4) correct answers Asymptomatic
Failed (or likely to fail) rhythm control
Adverse effects
Older patients
Which two agents have effects consistent with all four classes? correct answers amiodarone
dronedarone
Which two drugs need to be dosed for renal dysfunction? correct answers dofetilide
sotolol
What are three main DDIs with amiodarone and what do we do for these drug interactions?
correct answers Warfarin: decrease warfarin dose by 50%
Digoxin: decrease digoxin dose by 50%
Simvastatin: limit to 20 mg/day
What are some monitoring parameters with amiodarone? (5) correct answers BP, HR, EKG
rhythm
Baseline PFTs
TSH
Ophthalmic exams
Why do we need baseline PFTs?
Why do we need ophthalmic exams?
Why do we check TSH? correct answers Pulmonary fibrosis
