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Algorithm for the management of atrial fibrillation with rapid ventricular response

- Dr. Tom Fadial @thame 

#Atrial
management of atrial ... fibrillation with rapid ventricular ... Fadial @thame #Atrial ... #fibrillation #AFib ... Rapid #Emergency #Cardiology
Anatomical Differential Diagnosis for Arrhythmias
 • SA node: Sinus bradycardia, Sick Sinus Syndrome (SSS)
 • AV
• Ventricles: Ventricular ... Tachy-arrhythmias (ventricular ... Fibrillation (V-Fib ... Differential #Diagnosis #Causes ... #cardiology
Atrial Fibrillation - Diagnosis, Causes, Presentations
Causes (PIRATES):
 - Pulmonary embolism 
 - Ischemia (cardiac) 
 -
Atrial Fibrillation ... - Diagnosis, Causes ... Presentations Causes ... #Fibrillation #AFib ... PIRATES #Emergency #Cardiology
Ventricular Fibrillation on Echocardiogram (A4C)
Rare glimpse of echocardiogram just at the onset of VF, no organized
Ventricular Fibrillation ... on Echocardiogram ... ShariqShamimMD #VFib ... #Ventricular #Fibrillation ... #clinical #cardiology
Causes of Tachycardia - Differential Diagnosis Algorithm
Narrow Complex - Regular:
 • Sinus tachycardia
 • Atrial flutter
Causes of Tachycardia ... • Monomorphic ventricular ... • Polymorphic ventricular ... Diagnosis #Algorithm #Causes ... #cardiology
Approach to ECGs - Tachy/Bradyarrhythmias
Tachyarrhythmias - HR > 100
Wide
  (1) VT - DANGER
  (2)
abberancy - N B Afib ... (3) SVTs - atrial ... 200ms from longer pause ... Distal AV block - ventricular ... electrocardiogram #cardiology
POCUS Pearls for Tamponade
- Pericardial Effusion
- Diastolic Right Ventricular Collapse
- Systolic Right Atrial Collapse
- Plethoric Inferior
Diastolic Right Ventricular ... Systolic Right Atrial ... Diagnosis #Evaluation #Cardiology ... #Effusion #Echocardiogram
Arrhythmias - Differential Diagnosis Algorithm

Bradyarrhythmia (<60 bpm)
 • Sinus Bradycardia
 • Sick Sinus Syndrome
 • SA
Escape Rhythm • Ventricular ... • Premature ventricular ... interval) • AFib ... tachyarrhythmias #Cardiology ... Diagnosis #Algorithm #causes
Atrial Fibrillation (A-Fib) Summary

Symptoms:
• Palpitations, light-headedness, dizziness, dyspnea, exercise intolerance, chest pain, near-syncope, syncope.

Why?
Cardiac:
	• Valvular heart
Irregularly irregular ventricular ... (< 5% pts with afibb ... disease, left ventricular ... assess peak right ventricular ... diagnosis #management #cardiology
The cardiac cycle describes each heart beat, incorporating relaxation and contraction. Phase one describes diastole and
see above that atrial ... are both low but atrial ... blood when the atria ... the aortic valve closes ... #Pathophys #Cardiology