FIBRILASI ATRIUM Diagnosis dan Tatalaksana

ATRIAL FIBRILLATIONDiagnosis & ManagementZainuddin KhanSMF Kardiologi dan Kedokteran VaskularRSUD Tarakan, Jakarta

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2IntroductionAtrial Fibrillation Facts- Most common cardiac arrhytmia- Incidence : 1 2%- Increased prevalence with age- Public health problems

ESC Guidelines. Eur Heart J. 20103

CLINICAL EVENTS AND OUTCOME OF AFESC Guidelines. Eur Heart J. 20104DEFINITION AND DIAGNOSIS AF Cardiac arrhytmia with the following characteristics :Absolutely irregular RR intervalsNo distinct P wave on the surface ECGRapid and irregular ventricular response

ESC Guidelines. Eur Heart J. 20105

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7ETIOLOGY AND RISK FACTORS

ESC Guidelines. Eur Heart J. 20108PATHOGENESIS

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TYPES OF ATRIAL FIBRILLATIONESC Guidelines. Eur Heart J. 201010CLINICAL IMPACTRapid ventricular rate Progressive ventricular dysfunction Rate related cardiomyopathiesLoss of atrial transport decreased COIrregular ventricular depolarizations decreased COInappropriate rate increases with exerciseActivation of platelet and the coagulation system thromboembolic complications

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EHRA score of AF- related symptomsESC Guidelines. Eur Heart J. 201012THERAPY GOALS AND TREATMENTSRate control Reduce symptoms and rate related cardiomyopathiesRhythm control Restoration and maintenance of normal sinus rhythmRisk reduction Reduce the risk of strokeSymptom reduction Improve quality of life

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DCC and pharmacological conversion recent-onset AFESC Guidelines. Eur Heart J. 201014

The management cascade for patients with AFESC Guidelines. Eur Heart J. 201015

Rate control of atrial fibrillationThe choice of drugs depends on life style and underlying diseaseESC Guidelines. Eur Heart J. 201016

Drugs and doses for pharmacological conversion of (recent-onset) AFESC Guidelines. Eur Heart J. 201017

STROKE PREVENTION

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Risk factors for stroke andthrombo-embolism in non-valvular AFESC Guidelines. Eur Heart J. 201020

Risk factor-based point-based scoring system - CHA2DS2-VASc ESC Guidelines. Eur Heart J. 201021

Use of oral anticoagulation forstroke prevention in AF ESC Guidelines. Eur Heart J. 201022

Approach to thrombo Prophylaxis in AFESC Guidelines. Eur Heart J. 201023CONCLUSIONAF is the most common form of cardiac arrhythmiaResponsible for public health problemsCausing some clinical implicationsThe main therapy goals are: - reduce symptoms and rate-related cardiomyopathy as well as reduce the risk of strokeModalities of treatment : Drugs, DCC and catheter ablation24THANK YOU

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