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12 Cards in this Set
- Front
- Back
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Classification of Atrial Fibrillation
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Paroxysmal (self limiting) Persistent (fixed with cardioversion) Permanent (unable to be cardioverted) |
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Management of Atrial Fibrillation |
Fix rate Assess and control thromboembolism risk Fix rhythm (if possible) Fix causes and complications |
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Anticoagulants used in Atrial Fibrillation |
Warfarin Direct thrombin inhibitors Direct Xa inhibitors |
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Rate control drugs used in Atrial Fibrillation |
B-Blockers Rate-limiting calcium channel blockers Digoxin |
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Rhythm control drugs used in Atrial Fibrillation |
Amiodarone |
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B-blockers |
e.g. atenolol, metoprolol Inhibit b-adrenoceptors thus lowering cAMP and intracellular calcium. Side effects: hypotension, hypoglycaemia, bradycardia, heart block, bronchospasm. |
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Rate-limiting calcium channel blockers |
e.g. diltiazem, verapamil Inhibits L-type calcium channels in the SA node thus slowing the generation of the pacemaker potential. Side effects: bradycardia, headache, flushing, ankle oedema, constipation |
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Digoxin |
Inhibits Na+/K+ ATPase thus increasing intracellular Na. Intracellular Na is then processed at Na/Ca exchanger, increasing intracellular Ca which increases contraction force and decreases heart rate. Side effects: bradycardia, arrhythmia, visual disturbance, GI disturbance, confusion |
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Amiodarone |
Mechanism Unclear Side effects: arrhythmia, hypothyroidism, corneal deposits, lung fibrosis, liver abnormalities, rash. |
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Warfarin |
Inhibits vitamin K epoxide reductase thus prevents the gamma carboxylation of factors 2, 7, 9 and 10. Side effects: Bleeding, alopecia, skin necrosis, teratogenic |
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Direct thrombin inhibitors |
e.g. dabigatran directly inhibits thrombin thus prevents the conversion of fibrinogen to fibrin. Side effects: bleeding, GI disturbance, hepatobiliary disorders |
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Direct Xa inhibitors |
e.g. apixaban, rivaroxaban Directly inhibit factor Xa thus preventing the formation of a fibrin mesh Side effects: bleeding, nausea, renal impairment (rivaroxaban) |
