Atrial Fibrillation, known as “A-Fib” around the hospital and clinics, represents the most common cardiac arrhythmia encountered by medical professionals. While often asymptomatic, A-Fib can lead to palpitations, chest pain, syncope, heart failure, and even stroke.
Once diagnosed by physical exam or EKG, the management of A-Fib can be full of questions for clinicians—when should I cardiovert the patient? Do I anticoagulate with aspirin or warfarin? When do I order an echo? Do I administer AV nodal blockers or anti-arrhythmics? When do I refer to electrophysiology?
Simply put, managing A-Fib can be complicated and challenging for clinicians. Fortunately, there’s an app for that. Here we review the QxMD AF Guide, an Atrial Fibrillation Reference for physicians, available for the iPhone.
Founded by medical professionals, QxMD prides itself on “creating high quality, point-of-care tools for practicing health care professionals.” In addition to the AF Guide, QxMD has also developed free and paid apps to assist with OR safety, EKG interpretation, ICD-9 coding, medical interpretation for different languages, and an outstanding calculator (QxMD Calculate), which we took a look at in our recent free medical calculator comparison . In the case of the AF Guide, Jason Andrade, a Canadian cardiologist, authored the app.
As for the app itself, the home screen “AF Basics” has tabs for Introduction, Causes, Clinical Presentation, Classification, Symptom Class, Investigations, Management, and References. The index bar at the bottom offers quick access to Basics, Acute AF, Rate, Rhythm, and Calculators. Here, we’ll take a look at some of the most useful highlights of the app.
While the Introduction contains a short topical overview of A-Fib, the Causes section offers a concise category-organized list of potential etiologies of A-Fib. Classification facilitates the quick delineation of A-Fib into paroxysmal, persistent, permanent, or lone, by definition.
Likewise, Symptom Class facilitates the labeling of A-Fib symptoms.
“Investigations” expands into the subcategories of essential tests, additional tests, and a sample EKG.
Finally, Management briefly states the goals of treatment and a list of the factors affecting the choice of treatments.
As you can see, mastering this “AF Basics” section of the app, which contains information essential to the diagnosis, work-up, and classification of A-Fib, can – and perhaps should — be done rather quickly. Rather, where the real utility of this app lies are in the functions along the bottom index bar — Acute AF, Rate Control, Rhythm Control, and Calculators.
The Acute AF function offers a step-by-step approach for the management of acute AF, a frequent occurrence on almost any inpatient floor.
Acute AF also offers management options that assists with medication choice and dosing as well as parameters for electrical cardioversion. Unfortunately, much of this information for acute A-Fib is also contained within ACLS protocols.