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Dr SYED RAZA
MD,MRCP(UK),CCT(UK),MESC,Dip.Card(UK),FCCP
Consultant Cardiologist
OBJECTIVES
• Introduction
• Classification
• Burden of the problem
• Diagnosis
• Management
What is it ?
• Others
• Echocardiogram, CXR
• TFT, Electrolytes, Clotting, LFT,CBC
ECG Diagnosis
• extremely common
• Can lead to symptoms
• potentially serious consequences:
– embolism
– impaired cardiac output
– increased mortality
Management of Acute AF (<48 hrs)
• Haemodynamically unstable : hypotension/heart
failure/chest pain/syncope
Use DC Cardioversion
Haemodynamically stable :
Rate control : If significant tachycardia
Rhythm control : Flecainide, Propafenone (cl-I)
Amiodarone, Sotalol (cl-III)
Anticoagulant : LMWH
Treatment for permanent AF
• Heart Rate control
prevent tachycardia-associated
cardiomyopathy
• Anticoagulation
Rhythm control as preferred
therapy
• Beta blocker
• Calcium channel blocker
• Verapamil, diltiazem
. Digoxin
With AF
< 60 yrs : 3%
> 80 yrs : 30%
Lip Y, et al. Chest 2010, 137(2):263
How do we determine stroke risk ?