TREATMENT OF ATRIAL FIBRILLATION EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

TREATMENT OF ATRIAL FIBRILLATION EXAM QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 what is the most common type of dysrhythmia in adults? - Answers atrial fibrillation (AF) is AF more common in males or females? - Answers males common causes of AF - Answers -*HTN* -CAD -CHF -rheumatic mitral valve disease -hyperthyroidism -hypoxic conditions -surgery -alcoholism symptoms of AF - Answers -palpitations -lightheadedness -fatigue signs of AF - Answers -atrial rate 400-600 bpm -irregular atrial rhythm -irregular ventricular response -rapid or normal rate is AF caused by abnormal impulse formation or abnormal impulse conduction? - Answers both frequent or prolonged AF can lead to electrical ____________ of the atria - Answers remodeling type of AF; episodes begin suddenly and spontaneously, last minutes to hours, terminate suddenly and spontaneously - Answers paroxysmal A fib type of AF; episodes that do not terminate spontaneously, require medical intervention - Answers persistent A fib type of AF; never in normal sinus rhythm - Answers permanent A fib AF increases the risk of: - Answers -stroke -cardiomyopathy -heart failure -mortality what % of all *ischemic strokes* can be attributed to AF? - Answers 15% patients with AF need what type of therapy depending on their risk calculated from CHADS2? - Answers anticoagulant or antiplatelet therapy CHADS2 - Answers -CHF (1) -HTN (1) -Age 75+ (1) -DM (1) -Stroke/TIA history (2) CHADS2 high risk score - Answers 2+ medication for CHADS2 high risk (=2+) - Answers oral anticoagulant medication for CHADS2 intermediate risk (=1) - Answers oral anticoagulant or ASA + ADP inhibitor or oral anticoagulant alone or ASA alone medication for CHADS2 low risk (=0) - Answers no therapy or ASA daily acute treatment of AF - Answers -direct current cardioversion (DCC) -pharmacological cardioversion DCC is highly effective when AF is present __________ - Answers 3-4 months which is preferred: DCC or pharmacological cardioversion? - Answers DCC will DCC prevent AF from recurring? - Answers no function of DCC - Answers simultaneously depolarizes all of the myocardial cells which ideally will reset or terminate the multiple reentrant circuits and *restore normal sinus rhythm* pharmacological cardioversion meds - Answers -ibutilide -dofetilide -flecainide -propafenone -amiodarone treatment of choice in new onset AF (48 hours), symptomatic and hemodynamically *unstable* - Answers DCC immediately, follow with short-term heparin definition of hemodynamically unstable - Answers -altered mental status -SPB 90 -ventricular rate 150 -symptoms of MI is the risk of clot low or high in new onset AF? - Answers low risk treatment of AF onset 48 hours or unknown - Answers begin heparin, DCC immediately, follow with 4 weeks oral anticoagulant treatment goal of new onset AF (48 hours), symptomatic and hemodynamically *stable* - Answers attempt to control ventricular rate initial rate control for patients with *normal LV function* and new onset AF (48 hours), symptomatic and hemodynamically *stable* - Answers IV beta blockers, diltiazem, or verapamil initial rate control for patients with *LV dysfunction or hypotension* and new onset AF (48 hours), symptomatic and hemodynamically *stable* - Answers IV digoxin or amiodarone why must beta blockers *initially* be avoided in patients with LV dysfunction during acute onset AF? - Answers because of their potential to cause ADHF treatment goal of onset AF 48 hours or unknown duration, symptomatic and hemodynamically *stable* - Answers attempt to control ventricular rate is the risk of clot low or high in onset AF 48 hours? - Answers high risk what must you perform before CDD to detect presence of thrombus? - Answers transesophageal echocardiogram (TEE) what do you do if *no* thrombus is visualized? - Answers proceed with DCC or pharmacological cardioversion with short-term heparin followed by oral anticoagulant x 4 weeks what do you do if a thrombus is visualized? - Answers oral anticoagulant x 3 weeks before and 4 weeks after cardioversion, repeat TEE before attempting cardioversion findings of the AFFIRM trial - Answers rhythm control has not been shown to be superior to ventricular rate control in reducing morbidity and mortality appropriate treatment option for the majority of patients with chronic AF - Answers *rate control* along with chronic antithrombotic therapy maintenance therapy *ventricular rate* control in *normal LV function*: 1st line - Answers -beta blockers -diltiazem -verapamil digoxin is only effective for rate control at ________ - Answers rest maintenance therapy *ventricular rate* control in *normal LV function*: 3rd line - Answers amiodarone maintenance therapy *ventricular rate* control in *LV dysfunction*: 1st line - Answers beta blockers maintenance therapy *ventricular rate* control in *LV dysfunction*: 2nd line - Answers digoxin maintenance therapy *ventricular rate* control in *LV dysfunction*: 3rd line - Answers amiodarone maintenance therapy *ventricular rate* control in *LV dysfunction*: what about diltiazem or verapamil? - Answers NO, should be avoided in patients with EF 40% the risks of chronic antidysrhythmics to maintain *normal sinus rhythm* may ___________ the benefits for the majority of patients - Answers outweight treatment options for *rhythm control* - Answers -flecainide -propafenone -sotalol preferred treatment options for *rhythm control* in HF patients in order to avoid negative inotropes - Answers -amiodarone -dofetilide