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Ablation
Removal or excision of part of the body. |
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ACE (Angiotensin Converting Enzyme) inhibitor
A drug used in the treatment of hypertension and heart failure. |
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Algorithm
A flowchart or diagram representing decision points and alternative (treatment) pathways to achieve an objective or set of objectives. |
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Angina
Heaviness or tightness in the chest, which may spread to the arms, neck, jaw, face or back, due to inadequate blood supply for demands of the heart muscle. |
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Anticoagulation
Action by drugs to reduce the tendency of blood to coagulate, thereby reducing the risk of thrombosis. The most commonly used anticoagulant for people with AF is warfarin. |
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Antiplatelet agent/drug
Act against or destroy blood platelets. Blood plateletes help blood clotting. |
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Antithrombotic
Used against or tending to prevent thrombosis. |
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Arrhythmia
An abnormal heart rhythm that may be permanent, intermittent or transient. |
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Asystole
Cardiac standstill. |
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Atrial fibrillation
Rapid, irregular contractions of the heart. |
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Atrioventricular node
An area of specialised cardiac muscle that receives the cardiac impulse from the sinoatrial node and conducts it to the atrioventricular bundle, Purkinje fibres and walls of the ventricles. Located in the septal wall between the left and right atria. |
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Atrium (n)/ atrial (v)
One of two upper chambers of the heart. The right atrium receives deoxygenated blood from the superior and inferior vena cava and the coronary sinus, while the left atrium receives oxygenated blood from the pulmonary viens. |
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Attributable risk
The level of risk that is casually related to a particular factor or variable. |
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Beta-blocker
A drug which antagonises the effects of the sympathetic stimulation, thereby producing a slower heart rate, lower blood pressure and reduced heart muscle contraction leading to lessened oxygen demands of the heart muscle and hence decreasing angina pectoris. |
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Biphasic shock
Bidirectional, as opposed to unidirectional, shock pathway. |
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Bradycardia
A slowness of the heart beat, as evidenced by slowing of the pulse rate to less than 60 beats per minute. |
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Cardiomyopathy
Any disease of the heart muscle. |
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Cardiovascular disease
An all-encompassing term used to describe all diseases and conditions involving the heart and blood vessels. |
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Cardioversion
The restoration of the heart's normal sinus rhythm, either by drugs or synchronised electric shock. |
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Cohort study
An observational study that takes a group (cohort) of patients and follows their progress over time in order to measure outcomes and make comparisons according to the treatments or interventions that patients received. |
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Congestive heart failure
Heart failure in which the heart is unable to maintain adequate circulation of the blood or to pump out the blood returned to it. |
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Considered judgment
A decision based on all the of the available or specified evidence relating to a particular issue or question. The 'considered judgment' forms the basis for a recommendation, or a set of recommendations, in a evidence-based guidelne. |
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Coronary heart disease
Heart disease resulting from the atherosclerotic narrowings of coronary artery disease. |
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Defibrillator
A device that delivers an electric shock to the myocardium through the chest wall. |
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District Health Boards (DHBs)
Organisations established to protect, promote and improve the health and independence of geographically defi ned populations. Each DHB will fund, provide (or ensure) the provisions of health and disability services for its population. |
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Echocardiography
A diagnostic procedure for studying the structure and motion of the heart by using ultrasonic waves which are reflected backward ('echoed') when they pass from one type of tissue to another. |
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Ectopy
Pertaining to a beat or rhythm, occurring outside its normal location or at the wrong time. |
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Electrocardiography
A device used for recording the electrical activity of the myocardium to detect transmission of the cardiac impulse through the conductive tissues of the muscle for the diagnosis of specific cardiac abnormalities. |
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Electrophysiological
Concerned with the relationship between the electrical activity and biological function of the heart. |
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Euthyroid
Condition in which the thyroid gland is functioning normally. |
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Haemodynamic
Pertaining to the physical aspects of blood circulation, including cardiac function and peripheral vascular physiologic characteristics. |
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Haemorrhage
Loss of a significant amount of blood in a short period. |
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Half-life
The time required to reduce a drug level to half of its initial value. |
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Holter monitor
Portable tape recorder used to record electrocardiography measurements worn by a person during normal daily activites. |
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Hypertension
Abnormally high blood pressure. |
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Hypertrophy
An increase in the volume of a tissue or organ produced entirely by enlargement of the existing cells. In the case of AF, we are talking about hypertrophy of the heart. |
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Hypokalaemia
Low serum potassium concentration. |
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Hypotension
Abnormally low blood pressure. |
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Inotropic
Refers to the force of energy of ventricular contractions. |
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Inpatient
Person admitted to hospital for at least an overnight stay. |
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International Normalised Ratio (INR)
A standardised measurement of prothrombin time. |
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Intracranial
Within the skull. |
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Intravenous
If referring to drug injection or infusion, administered inside the vein. |
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Ischaemic stroke
Stroke caused by obstruction (as by a blood clot) of a blood vessel of the brain. |
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Left ventricular dysfunction
Abnormal function of the left ventricle; the chamber of the heart that pumps blood through the aorta and the capillaries back through the veins to the right atrium. |
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Lone AF
AF in younger people (aged <60 years) without clinical or echocardiographic evidence of cardiopulmonary disease. |
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Maintenance therapy
Treatment to prevent recurrence of a medical condition or disease. |
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MAZE
A surgical intervention that interrupts the circular electrical patterns caused by AF. Strategic placement of incisions in both atria of the heart, causes scar tissue that permanently blocks the travel routes of the errant electrical impulses, and channels the normal electrical impulse in one direction from the top of the heart to the bottom. |
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Monophasic shock
Uni-directional shock pathway. |
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Myocardial infarction
Damage or death to heart muscle that results typically from the partial or complete blockage of a coronary artery (i.e. occlusion). |
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New-onset atrial fibrillation
First known occurrence of atrial fibrillation. |
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Nonsteroidal anti-imflammatory drug
A group of drugs having antipyretic, analgesic and anti-inflammatory effects. |
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Nonvalvular atrial fibrillation
Atrial fibrillation that occurs in the absence of rheumatic mitral valve disease or a prosthetic heart value. |
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Open label
Not blinded or masked. |
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Outpatient clinic
A general medical clinic focused on medical rather than rehabilitation problems and outcomes. |
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Pacemaker
A cardiac device used to electronically stimulate the heart muscle. |
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Pacing
The artificial electrical stimulation of a heart rhythm. |
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Paroxysmal atrial fibrillation (PAF)
Atrial fibrillation that spontaneously reverts to normal sinus rhythm without a cardioversion procedure or therapy, but tends to recur intermittently. |
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Permanent atrial fibrillation (AF)
AF that is known to be unresponsive to cardioversion therapy, ie, cannot be converted to normal sinus rhythm by either electrical or pharmacological means. Permanent AF also includes cases of long-standing AF (eg, greater than one year) in which cardioversion has not been indicated or attempted. |
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Persistent atrial fibrillation
Atrial fibrillation that does not spontaneously revert to normal sinus rhythm, but can be converted by either electrical or pharmacological cardioversion therapy. |
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Pharmacological
Pertaining to drugs. |
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Prevalence
A measure of the proportion of people in a population who have some attribute or disease at a given point in time or during a specified time period. Point prevalence is the number of cases at one point in time and period prevalenced is the number of cases over a specifed time period (includes both the new [incident] cases over the period and existing cases of disease at a point in time). |
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Primary health care
Usually the health services of first point of contact based around key health practitioners or providers, such as general practitioners. It is generally community-based, but can include hospitals and other health services. It can also refer to essential health care made available universally to individuals and families in the community, by means acceptable to them. |
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Proarrhythmia
Drug-induced cardiac arrhythmia; an umbrella term for many different types of cardiac arrhythmia, including torsades de pointes. |
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Prophylaxis
Preventive treatment. |
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Prothrombin time
Measurement of plasma clotting time. |
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Pulmonary
To do with the lungs. |
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QRS
A series of wave forms on electrocardiograph representing depolarisation of the ventricles. |
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QT interval
The part on an electrocardiograph from the beginning of the QRS complex to the end of the T wave, reflecting the length of the refractory period of the ventricle. |
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Quality adjusted life year (QALY)
A measure used in quality of life and health economic studies; years of life gained or preserved, adjusted to reflect the quality of that life as measured by standardised and validated questionnaires. |
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Radiofrequency
Using energy in the radio wavelength band. In this context, the radiofrequency energy is delivered via electrode catheters that are introduced via blood vessels of arms or legs, through which their tips are manipulated into the chambers of the heart. |
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Rate control
Control of the heart rate; in this context, reducing the heart rate to within specified ranges while at rest (60 to 80 bpm) and during moderate exercise (90 to 115 bpm). |
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Remodelling
Changes in the atria of the heart that makes atrial fibrillation progressively more difficult to treat the longer it continues. There are three types of remodelling: electrical, contractile and structural. |
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Rheumatic heart disease
Damage (often caused by an autoimmune reaction to a streptococcal infection) to the heart muscle and heart valves caused by episodes of rheumatic fever (an inflammatory disease that may develop as a delayed reaction to inadequately treated streptococcal infection of the upper respiratory tract). |
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Rhythm control
Control of the heart rhythm; in this context, converting atrial fibrillation or flutter to normal sinus rhythm. |
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Risk factor
An aspect of personal behaviour or lifestyle, an environmental exposure, or an inherited characteristic that is associated with an increased risk of a person developing a disease. |
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R-R
Time interval between successive QRS complexes. |
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Sinus rhythm (SR)
Heart rhythm stimulated by the sinoatrial node of the heart. Normal sinus rhythm is considered to be 60 to 100 beats bpm. |
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Stakeholders
Individuals or groups that have an interest in, or are likely to be affected by, a change in policy in approach. |
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Stroke
Sudden decrease or loss of consciousness, sensation, and movement caused by rupture or obstruction (as by a blood clot) of a blood vessel of the brain. Stroke is characterised by rapidly developing symptoms and signs of a focal brain lesion, with symptoms lasting for more than 24 hours or leading to death, with no apparent cause other than of vascular origin. |
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Subcutaneous
Beneath the skin. |
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Syncope
Fainting or loss of consciousness induced by a temporarily insufficient flow of blood to the brain. |
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Tachycardia
Rapid heart action. This maybe regular and normal (sinus tachycardia), arise from the atrium (atrial tachycardia, flutter or fibrillation), from the conduction system (supraventricular tachycardia) or from the ventricles (ventricular tachycardia). |
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Tachycardia-bradycardia syndrome
Alternating rapid and slow rates in atrial fibrillation, or alternatively a pause and/or bradycardia following spontaneous conversion to sinus rhythm. |
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Therapeutic
Related to treatment and healing. |
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Thrombin inhibitor
An inhibitor of the substance thrombin. Thrombin acts as an enzyme, converting the soluble protein fibrinogen to the insoluble protein fibrin in the final stage of blood cagulation. |
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Thromboembolic
Related to the condition in which a blood clot (thrombus), formed at one point in the circulation, becomes detached and lodges at another point. |
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Thrombus/thrombi
Blood clot(s). |
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Thyrotoxicosis
The syndrome caused by excessive amounts of thyroid hormones in the bloodstream. |
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Torsades de pointes
Literally 'twisting of points'; a polymorphic ventricular tachycardia with a characteristic twisting around the iso-electric line of the ECG. This is one of the most serious potential side effects of antiarrhythmic agents, as it can cause suden death. |
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Toxicity
The degree to which a substance is poisonous or harmful. |
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Transient ischaemic attack
A brief episode of reduced blood flow to the brain. Symptoms are 'stroke-like' – with temporary blurring of vision, slurring of speech, numbness, and muscle weakness common features – and last less than 24 hours.
Transient ischaemic attacks (TIAs) are not included in the definition of stroke even though they have a common cause. TIAs may be the precursor of a stroke; therefore patients who have had a TIA require urgent assessment and treatment. |
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Transoesophageal
Across or through the oesophagus. |
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Transthoracic
Across or through the thorax (chest and ribcage). |
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Ventricle (n)/ ventricular (v)
Either of the two lower chambers of the heart. The left entricle receives blood from the pulmonary veins via the left atrium and pumps it into the aorta. The right ventricle pumps blood received from the venae cavae (via the right atrium) into the pulmonary artery. |
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Contraindication
Any factor in a person’s condition that makes it unwise to pursue a certain line of treatment. |
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Critical appraisal
A systematic review of a research report, using a standardised appraisal tool, to determine the quality of the paper (level of evidence, precision, etc) and its relevance to the question being asked. |
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Evidence-based medicine / health care
The process of finding relevant information in the medical literature to address a specific clinical problem. Patient care based on evidence derived from the best available studies. |
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Incidence
The number of new events (new cases of a disease) in a defined population, within a specified period of time. cf prevalence. |
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Medication
A substance administered by mouth, applied to the body or introduced into the body for the purpose of treatment. |
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Meta-analysis
Describes when statistical techniques are used to combine the results of a number of studies about the same topic. Meta-analysis is often used as part of a systematic review, that uses an explicit approach to identify, select and appraise relevant studies. The studies are then collectively analysed to give pooled results (as opposed to the ?ndings of a single study). |
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Number needed to treat (NNT)
cf number needed to harm (NNH). When the treatment reduces the risk of specified adverse outcomes of a condition, NNT is the number of participants with a particular condition who must receive a treatment for a prescribed period in order to prevent the occurrence of the adverse outcomes. This number is the inverse of the absolute risk reduction. |
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Primary prevention
Strategies undertaken to limit the incidence of disease or injury by controlling causes and risk factors. |
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Prognosis
The possible outcomes of a disease or condition and the likelihood that each one will occur. |
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Randomised controlled trial (RCT)
An experimental comparison study in which participants are allocated to treatment / intervention or control / placebo groups using a random mechanism, such as coin toss, random number table, or computer-generated random numbers. Participants have an equal chance of being allocated to an intervention or control group and therefore allocation bias is eliminated.
Randomisation relies on large subject numbers to be successful as bias can occur by chance clustering of characteristics even in RCTs. Any RCT shold therefore analyse subject groups for potential differences.
Trials in which people in a population are randomly allocated into two groups, usually called study and control groups, to receive or not to receive an intervention. For trials to assess screening procedures, the study group is offered screening and the control group is not. The results are assessed by comparing rates of death (or other end points) from the disease in the two groups. RCTs are generally regarded as the most scientifically rigorous method of assessing the efficacy of screening. |
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Relative risk or risk ratio (RR)
Ratio of the proportions in the treatment and control groups with the outcome. This expresses the risk of the outcome in the treatment group relative to that in the control group. |
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Secondary health care
Public hospitals, hospital-based services and specialist services. |
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Secondary prevention
Strategies undertaken to cure patients and reduce the more serious consequences of disease through early diagnosis and treatment. |
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Systematic review
The process of systematically locating, critically appraising and synthesising evidence from scientific studies in order to obtain a reliable overview. |
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Validity
Of measurement: an expression of the degree to which a measurement measures what it purports to measure; it includes construct and content validity.
Of study: the degree to which the inferences drawn from the study are warranted when account is taken of the study methods, the representative-ness of the study sample, and the nature of the population from which it is drawn (internal and external validity, applicability, generalisability).
The internal validity of a study refers to the integrity of the experimental design.
The external validity of a study refers to the appropriateness by which its results can be applied to non-study patients or populations. |
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