Palpitations & Atrial Fibrillation

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Palpitations & Atrial Fibrillation. Dr Mehul B Dhinoja , Consultant Cardiologist & Electrophysiologist BMI The London Independent Hospital. Palpitations. Situations. Duration. Beginning. Frequency. During. Other symptoms. Ending. Family history. Gold standard for diagnosis. - PowerPoint PPT Presentation

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Palpitations & Atrial FibrillationDr Mehul B Dhinoja, Consultant Cardiologist & ElectrophysiologistBMI The London Independent HospitalvPalpitationsSituationsBeginningDuringEndingDurationFrequencyOther symptomsFamily historyvGold standard for diagnosis

vWhich recording method?24 hour Holter48 hour Holter72 hour Holter7 day HolterEvent recorderLoop recorder12 lead ECGSymptom frequency

Information requiredvOther investigationsThyroid functionCardiac MRICardiac CTCardiac catheterCardiac biopsyProvocation testingEchocardiogramGenetic testingvExample

v

Consequences of AFvTreatment goals in AF

European Society of Cardiology, 2010v

Risk stratificationEuropean Society of Cardiology, 2010 2vStroke preventionAnticoagulationWarfarinNovel Oral AnticoagulantsUnsuitableLeft Atrial Appendage OcclusionCHADS-VASC 2DabigatranRivaroxabanApixabanvRate controlLV functionTachy-BradySyndromeBiventricular PacemakerAV nodal AblationGoodImpairedBeta BlockersCalcium BlockersDigoxinBeta BlockersDigoxinTachy-BradySyndromeHF DrugsSingle Chamber PacemakerICD Indication?Review medicationsvRhythm controlImpairedLV function Coronary diseaseRecurrent symptomatic AFAF ablationNoYesFlecainideSotalol(Dronedarone)(Sotalol)HF DrugsDisopyramide/Propafenone(Dronedarone)(Amiodarone)DC cardioversionvUnderlying conditionsAtrial fibrillationHeart failureCardiomyopathiesInherited arrhythmiasVascular DiseaseObstructive SleepApnoeaDiabetes MellitusHypertensionThyrotoxicosisNonev

Prognosis after AF ablationHunter et al, 2011v

Prognosis after AF ablationHunter et al, 2011v