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CC May 2016 Catheter Ablation and Atrial fibrillation

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echoecho's version from 2016-07-24 17:59

Section

Question Answer
What is the most common sustained arrhythmia in the US?atrial fibrillation
AF presents with an estimated ______ new cases every year and a total of 6 million cases?200,000
AF is more common in what 2 groups?1) elderly 2) men
List the identified risk factors of AF?1) HTN 2) heart failure 3) CAD 4) MI 5) valvular heart disease
AF may result in what symptoms in individuals with impaired ventricular function?1) decreased exercise tolerance 2) fatigue
The presence of AF increases an individual's risk of what by about 5-fold?embolic stroke
What were the outcomes when strategies of rhythm control (i.e., converting AF to normal sinus rhythm either pharmacologically OR through direct cardioversion) were compared with anticoagulation and rate control?outcomes were SIMILAR between patients who were candidates for either strategy
What may be the cause of AF that may predispose a patient to remain in AF?clusters of cardiac ganglion plexuses in the vicinity of the pulmonary vein-left atrial junction may become exicte din the setting of left atrial enlargement providing an ectopic source of electrical activity for AF
What is AF ablation?it is a catheter-based technique in which radiofrequency waves or freezing is used to destroy the atrial tissue involved in the dysrhythmia and as a result, this produces a barrier between the pulmonary veins and the left atria, isolating the "trigger"in the pulmonary veins from the "substrate" of the atrial tissue
Discuss the evidence regarding AF ablation techniques as to reducing the incidence of recurrent atrial tachycardias (AF, atrial flutter, atrial tachycardia) vs. the long-term outcomes such as mortality, stroke risk or heart failure?evidence shows that AF ablation is effective in reducing recurrent atrial tachycardias (AF, atrial flutter, atrial tachycardia) but there is no evidence about long-term outcomes of mortlaity, stroke risk or heart failiure
List the risks of ablation?1) cardiac tamponade 2) cardiac perforation 3) cerebrovascular thromboembolism 4) phrenic nerve injury
What is the CHADS2 score criteria for those undergoing AF catheter ablation and should continue to receive anticoagulation?CHADS2 score > 1
*** In 2014, the American Heart Assoc / American College of Cardiology issued an updated guideline for management of AF? List these 3 updates?1) AF catheter ablation is useful in SYMPTOMATIC patients wtih paroxysmal AF who are refractory to or intolerant of medical therapy, and when rhythm-control strategy is desired. AF catheter-ablation may be considered for first-time treatment of symptomatic paroxysmal AFTER the risks and benefits of drug vs catheter rhythm-control are weighed 2) AF catheter ablation may be reasonable for some patients wtih SYMPTOMATIC PERSISTENT AF that is refractory to medical therapy or who are intolerant of medical therapy 3) patients who CAN NOT be treated with anticoagulation during and after the procedure should NOT have AF catheter ablation
A randomized controlled trial found that patients with paroxysmal AF who did NOT respond to one _______ drug, catheter ablation reduced the risk of symptomatic recurrence compared to pharmacotherapy alone?antiarrhythmic
A more recent randomized controlled trial of treatment-naive patients with paroxysmal AF found a lower rate of recurrent atrial tachyarrhythmias in the first ____ years for those treated with ablation compared to pharmacotherapy, but recurrence was freuqent in both groups?2
*** SUMMARY = What is AF ablation?a catheter-based technique in which radiofrequency waves or freezing is used to destroy atrial tissue involved in the dysrrhythmia
*** SUMMARY = Patients who undergo AF catheter ablation and have a CHADS2 score > ____ should continue to receive anticoagulation?1
*** SUMMARY = Catheter ablation is an option for some patients with _______ paroxysmal AF?symptomatic
*** SUMMARY = AF catheter ablation may be reasonable for some patients with symptomatic persistent AF that is refractory to what two things?1) medical therapy 2) intolerant of medical therapy
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