CC March 2017 Ablation Procedures for Atrial Fibrillation

echoecho's version from 2018-04-11 04:02


Question Answer
What is the most common persistent dysrhythmia in the US and worldwide?Atrial fibrillation
List the risk factors for the development of AF?1) diabetes 2) sleep apnea 3) obesity 4) HTN 5) smoking 6) alcohol use 7) structural heart disease 8) coronary heart disease 9) genetic factors
List the complications of AF?1) stroke from embolic events 2) heart failure 3)syncope 4) fatigue 5) increase in overall mortality
What is the underlying etiology of AF?it is not completely understood, but remodeling of atrial tissue leads to autonomous atrial impulses that are transmitted through the AV node, resulting in irregular heart rhythm
What is one unique feature of AF?the longer AF persists, the more atrial remodeling occurs, making it more refractory to treatment
In addition to dysrhythmia, there is loss of the synchronized " _____ _____" associated with decreased ventricular filling and output?atrial kick
AF patients are at risk for developing ____ _____ appendage thrombus that increases the risk of stroke from an embolic event?left atrial
Treatment of AF consists of what?1) normalization of cardiac rhythm when possible 2) control of ventricular response to prevent tachycardia 3) prevention of stroke (like control of HTN and DM, use of medications, lifestyle approaches)
For pts who continue to be symptomatic despite adequate rate control, intervention to restore what should be considered? This is popular in patients with what type of AF and as a primary treatment in AF to prevent what?1) normal sinus rhythm 2) paroxysmal AF 3) additional atrial remodeling
Several ablation techniques have been developed to restore normal sinus rhythm, name these?1) via a catheter 2) as open cardiac procedure OR 3) a hybrid of both surgical- and catheter-based approaches
List the indications for catheter - based ablation (radiofrequency or cryoballoon)?1) primary management of paroxysmal AF 2) management of AF poorly-controlled by medical therapy 3) primary management of AF in younger patients to avoid progressive disease
*** Is ablation indicated soley to avoid anticoagulant therapy?no; although restoration of normal sinus rhythm may eventually lead to cessation of anticoagulation therapy, ablation should be undertaken for the primary reasons of primary mgmt of paroxysmal AF, mgmt of AF poorly controlled by medical thearpy, primary management of AF in younger patients to avoid progressive disease
*** True or false? Patients undergoing ablation do not require anticoagulation thearpy prior to, during and after the procedure?false, they do require anticoagulation before, during and after the procedure
*** Which of the following are superior to the other, catheter ablation or antiarrhythmic medical therapy?catheter ablation is superior to antiarrhythmic medical therapy
*** True or false? For patients with symptomatic paroxysmal AF who do not have significant comorbidities, the catheter ablation procedure is superior? true
*** Why does the procedure require a highly skilled and trained electrophysiologist?due to potential complications
*** SUMMARY = Treatment of AF consists of _______ of rhythm, control of ______ response to prevent tachycardia and prevent of _____?1) normalization 2) ventricular 3) stroke
*** SUMMARY = True or false? Normalization of rhythm can be attempted with medical therapy, but ablation procedures are effective alternatives for symptomatic patients who are refractory or intolerant to medications?true
*** SUMMRY = What is considered superior to medical therapy in controlling AF for symptomatic patients with paroxysmal AF?catheter ablation