AF AF Pharmacology & Medications 2

Question 1

Which calcium channel blocker is used for rate control in AF but is contraindicated in heart failure with reduced ejection fraction?

Accepted Answer

Verapamil

Answer

Verapamil (and diltiazem) are non-dihydropyridine calcium channel blockers used for rate control in AF but are contraindicated in HFrEF due to their negative inotropic effects.

Question 2

The 'pill-in-the-pocket' approach to rhythm control in AF typically uses which agent?

Accepted Answer

Flecainide or propafenone

Answer

The pill-in-the-pocket strategy uses flecainide or propafenone taken as a single oral dose at AF onset to self-terminate infrequent, symptomatic AF episodes.

Question 3

Which score is used to assess bleeding risk before initiating anticoagulation in AF patients?

Accepted Answer

HAS-BLED

Answer

The HAS-BLED score estimates annual bleeding risk in anticoagulated AF patients by scoring hypertension, renal/liver dysfunction, stroke history, bleeding history, labile INR, elderly age, and drug/alcohol use.

Question 4

Dofetilide is a Class III antiarrhythmic that requires initiation in a monitored hospital setting primarily because of the risk of:

Accepted Answer

QT prolongation and torsades de pointes

Answer

Dofetilide can prolong the QT interval and precipitate torsades de pointes, requiring at least 3 days of in-hospital cardiac monitoring during initiation.

Question 5

What is the mechanism of action of ibutilide in AF management?

Accepted Answer

Activates slow inward sodium current and blocks potassium channels to prolong repolarization

Answer

Ibutilide is an IV Class III agent that prolongs cardiac repolarization by activating the slow inward sodium current and blocking potassium channels, enabling pharmacologic cardioversion of AF.

(AF) Atrial Fibrillation Certification Practice Test

(AF) Atrial Fibrillation Certification Practice Test

AF AF Pharmacology & Medications 2