Therapy For The Elderly With Atrial Fibrillation Essay

This case study discusses the management of a 68 year old male who presented with chest palpitations secondary to rapid atrial fibrillation. Atrial fibrillation is a common cardiac arrhythmia with serious complications if not treated correctly. This essay will discuss the initial clinical presentation of the patient and examine the management and outcome of the interventions applied. The significance of atrial fibrillation including its pathophysiology and aetiology will also be discussed.

Most physicians and people who acquired the problem usually know it as A-FIB, a shorter term for atrial fibrillation. Atrial fibrillation deals with the cardiovascular system, in particular, the heart in the body. It is defined as, “the electrical signals that control this system are off-kilter. Instead of working together the atria do their own thing, causing fast fluttering heartbeat, also known as arrhythmia” (WEBMD). In a normal pumping blood of the heart the atria would squeeze first, followed by the ventricles of the heart. A-fib can be a serious issue if not treated, due to the inadequate pumping of the blood, causing a higher chance of heart failure. It is also a higher chance in getting a stroke, because improper flow of the blood can cause clots in the

Coumadin (non specific name: warfarin) is an anticoagulant, or blood diminishing drug, that is endorsed to numerous patients who are at danger for creating blood clusters that could bring about heart assaults or strokes. Warfarin is near the most astounding purpose recently and simultaneous investigations of medications that provoke ER visits and occurring an expansion in healing center based offices with the affirmation of patients. Anticoagulation treatment stances perils to patients and over and over prompts unfavorable solution events in light of complex dosing, fundamental ensuing watching, and clashing patient consistence. As a result, various patients who meet current evidence based principles for warfarin treatment are not being managed

Health, N. I. (2013, April 17). U.S. National Library of Medicine. Retrieved from http://www.bradenscale.com/: https://www.nlm.nih.gov/research/umls/sourcereleasedocs/current/LNC_BRADEN/

- Coagulation inhibitors and Fibrinolysis : to Localize thrombus on injury and Prevent new thrombus formation.

Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P

When one begins to discuss issues that arise with an intrinsic organ, things get serious. Unfortunately, vital organs like the heart and liver that are causing problems can’t be removed like the appendix or the kidney and “cure” people of issues such as Appendicitis or constant dealings with gallstones. This is true when things begin to go awry within the heart and conditions begin to arise. Atrial Fibrillation (A-fib) is the most common type of arrhythmia, or issue with the heart rate or rhythm. Though A-fib is not a condition that is life-threatening, depending on the severity and lack of treatment, this condition leads to more serious issues like heart disease, and even heart attacks and strokes, which are usually what end up being the cause of death in individuals diagnosed with the condition. Because of A-fib leading to other more detrimental problems, such as the ones listed above, it is difficult to identify and pinpoint if someone has it or had it, which is why it is known as one of the contributors to the “silent killer,” also known as the heart attack. In this paper, gaining a deeper understanding of Atrial Fibrillation will be accomplished through the exploration of: causes, diagnosis, symptoms and treatment, the variation of types, what all is affected within the body as a result, what happens physically, and what occurs at the cellular level when diagnosed with this disorder. All in all, Atrial Fibrillation should be taken seriously and further research is

Preventing errors relating to commonly used anticoagulants. (2008). Joint Commission perspectives. Joint Commission on Accreditation of Healthcare Organizations, 28(11), 13-15.

The main concerns regarding treating a patient with AF are rhythm control, rate control, and anticoagulation (Zak, 2010). For patient X, he was started on Metoprolol (beta blocker), Amiodarone (anti-dysrhythmic) and Warfarin (anticoagulation). Due to Warfarin’s ability to alter the INR of the blood, it is imperative to monitor the INR frequently to ensure that the level is therapeutic (Shea and Sears, 2008). Patient X had a full time job though making minimum wage. He was unable to take time off of work to get his blood drawn monthly for INR levels at his doctor’s office. This would result in sub therapeutic levels of anticoagulation and therefore noncompliance. He suffered a pulmonary embolus from the sub therapeutic anticoagulation and was hospitalized. After speaking with his cardiologist regarding other means of anticoagulation, the decision was made to change his medication from Warfarin to Pradaxa, an anticoagulant of a different

For decades, Warfarin has remained the anticoagulant of choice for the prevention of cardiac thromboembolic disease in atrial fibrillation patients and in the treatment of deep vein thrombosis and pulmonary embolism. VKAs are clinically effective as an antithrombotic agent in Atrial Fibrillation, as dose adjusted warfarin has been proven to cut the risk of stroke by 64% (95% CI, 49%-74%) and all-cause death rate by 26% (95% CI, 3%-43%) [2]. In order to attain optimal anticoagulation effect of warfarin, frequent plasma level monitoring of International Normalized Ratio (INR) is required to maintain it in therapeutic range (INR 2-3) but maintaining the INR in therapeutic range is challenging and for many patients is achieved only approximately 55% of the time [3]. Thus, this finding counteracts the potential benefits of warfarin and increases its risks. A combination of factors like an inconvenience for patients and clinicians to use warfarin, large variability in plasma level of the drug affected by ethnicity and genetic polymorphism [4,5], interactions with various foods and drugs and the potential for serious hemorrhage e.g. Intracranial bleeding, have limited the widespread use of warfarin as an effective anticoagulant in nonvalvular atrial fibrillation (NVAF) [6]. Keeping in mind these facts about

Atrial Fibrillation is one of the leading causes of death across the globe. (1) AF increases an individual’s risk of stroke by 4 to 6 times on average. (2)(3) The risk increases with age, in people older than 80 years old; AF is the straight cause of 1 in 4 strokes. (3) Even though Atrial Fibrillation can be considered a mild arrhythmia; it is still associated with serious morbidity and mortality. (4)(5) First, it raises the risk of having thromboembolism and stroke, due to blood stasis in the left atrium. Stroke is commonly caused by a thrombus or clot. In patients with AF, the thrombus or clot is usually comes from the left atrial appendage (a small sac in the left upper chamber of the heart). Because stroke in AF patients may be particularly distressing, it is quite important to identify patients who are possibly at high risk before it occurs to them. Second, the irregularly irregular heart beat can cause symptoms palpitations, shortness of breath, anxiety and reduced exercise tolerance in the patient, so it requires medical consideration. Third, Atrial Fibrillation causes a lot of cardiac and hemodynamic changes including decreased myocardial systolic function and cardiomyopathy caused by tachycardia. (6)(7) Sometimes AF is identified only with the onset of a stroke or a transient ischemic attack (TIA or "mini-stroke"). (8) Whether if it is asymptomatic or symptomatic, AF is a progressive disease, worsening with time and it is accounting for

Today millions of Americans live or have lived with Atrial fibrillation. The main concern with this health issue is that many people who lived with it sometimes are not aware of it. Atrial fibrillation is defined by Mayo Clinic (2012) as “an irregular and often rapid heart rate that commonly causes poor blood flow to the body”. It occurs when the four chambers of the heart have a disrupted rhythm. The abnormal functionality of health may lead to a stroke because of the possible blood clot that will be formed. The Atrial fibrillation or Afib put the body in a situation without oxygen and nutrients because the body is not well supplied by a heart that is became weak. In general, only few people will feel change in their heartbeat. They may verbalize

The period entered for the search was from January 2002 to August 2015. The Search terms were: “dual antiplatelet therapy”, “shortened DAPT”,”, “clopidogrel”, “early discontinuation”, “Drug-eluting stenting in diabetes mellitus AND Dual Antiplatelet Therapy”, “extended DAPT”, “prolonged DAPT”, “gastroenteritis AND clopidogrel”, “Delayed eosinophilic gastroenteritis and gastroenteritis”, “thienopyridine”, “P2Y12”, “premature cessation “drug eluting stents AND diabetes” , “duration of dual antiplatelet therapy”. The search had to be modified to include patient’s co-morbidities, medications and medical condition. The search initially started with optimal duration of dual antiplatelet therapy in patients after drug-eluting stent revascularization, and then the search was broadened to include diabetic patients with drug-eluting stent. Lastly I included gastroenteritis to unearth any relation between clopidogrel and Mrs GL’s hospital admittance.

Watchman Left Atrial Appendage Closure Device for Embolic Protection in patients with Atrial Fibrillation (PROTECT AF) was a randomized, unblinded, multicenter trial conducted at 59 hospitals.a It involved 707 patients who were ≥18 years old with NVAF, had one or more CHADS2 risk factors (age >75 years, hypertension, diabetes, heart failure or left ventricle systolic dysfunction, prior transient ischemic attack or stroke), and were eligible for long-term anticoagulation with warfarin. Exclusion criteria included presence of patent foramen ovale with atrial septal aneurysm, atrial septal defect, mechanical valve prosthesis, left ventricular ejection fraction 97.5% (the non-inferior margin was a rate ratio [RR] of 2.0 comparing event rates between treatment groups). Superiority was defined by a probability ≥95%.

,platelet count at cutoff less than 74000 mm3 is significant in prediction of variceal bleeding risk with sensitivity 82.5% and specificity 55%. and platelet count/spleen diameter ratio (PC/SD) at cutoff 851.6 is significant in prediction of variceal bleeding risk with sensitivity 45% and specificity 90%.(table 5)