multaq hf script

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V H F

V H F Introduction

Script text

WelcometothecourseonMultaq.LetusabouttheapplicationofMultaqintreatingthe

instancesofstrokeduetoatrialfibrillation.

Visual Description

Fadeincharacterinadoctor’ssuit.AlsouseMultaq (SanofiAventis)logointhe

backgroundonthescreen.



(Feedbackforallassessments:

Whenuserselectscorrectlabel,say“Thatiscorrect”or“Correct”

Whenuserselectsincorrectlabel,say“Thatisincorrect”or“Incorrect”)



Module 1: Human Anatomy for Heart

Script text

Inthismodule,letuslearntheanatomyoftheheartanditsroleinthehumanbody.By

theendofthismoduleyouwillbefamiliarwith:

Importanceoftheheartinthehumanbody.

DetailedAnatomyofthehumanheart.

Visual Description

Fadeinthecharacter.OntheLCDscreenfadeinaheart.Zoomintotheheart.

Fadeouttheheart,ontheLCDputthebulletedtext.



Frame 001

Script text

Theheartisamuscularorganresponsibleforpumpingbloodthroughthebloodvessels

byrepeatedandrhythmiccontractions.Theheartofavertebrateiscomposedofcardiac

muscle,aninvoluntarymuscletissue.Theheartisapartofthecirculatorysystem.The

heartpumpsoxygenatedbloodtothebodyanddeoxygenatedbloodtothelungs.

Visual Description

Fadeinthecharacter.OntheLCDscreenfadeinaheart.Zoomintothescreen.

Showtheheart.Fadeinthecirculatorysystem.

Showtheheartasapartofthecirculatorysystem. Don’tlabelthecirculatorysystem.



Frame 002

Script text



Letusunderstandtheanatomyoftheheart.Thehearthasthreelayers.Theinsidelining

oftheheartiscalledtheendocardium.Themiddlelayerofheartmuscleiscalledthe

myocardium.Itissurroundedbyafluidfilledsaccallthepericardium.Theheartis

dividedintofourchambers:rightatrium(RA),rightventricle(RV),leftatrium(LA)andleft

ventricle(LV)

Visual Description

Showtheheart.Labelthefourchambers.



Frame 003

Eachchamberhasaone-wayvalveatitsexitthatpreventsbloodfromflowing

backwards.Whenachambercontracts,thevalveopensandbloodflowisestablished.

Whenitisfinishedcontracting,thevalveclosessothatblooddoesnotflowbackwards.

Thefourvalvesare:

Thetricuspidvalve:Attheexitoftherightatrium.

Thepulmonaryvalve:Attheexitoftherightventricle.

Themitralvalve:Attheexitoftheleftatrium.

Theaorticvalve:Attheexitoftheleftventricle.

Visual Description

Onthescreen,zoomintothelabeleddiagram.



Frame 004

Script text

Whentheheartmusclecontractsorbeats(calledsystole),itpumpsbloodoutofthe

heart.Therightsideoftheheartcollectsoxygen-poorbloodfromthebodyandpumpsit

tothelungswherethebloodpicksupoxygenandreleasescarbondioxide.

Theleftsideoftheheartthencollectsoxygen-richbloodfromthelungsandpumpsittothebodysothatthecellsthroughoutyourbodyhavetheoxygentheyneedtofunction

properly.Thus,theheartplaysaveryimportantroleinthebody.

Visual Description

Zoomintotheheart.

Showdeoxygenatedbloodflowingintotheheartinbluecolour.

Showthisbluebloodtowardsthelungs.

Inthelungs,thebloodpicksupoxygenandreleasesCO2.Changeitscolourtored.

Showtheoxygenatedbloodinredcomingtotheheart.Andfromtheheartflowing

towardsthebody.



Frame 005 – Assessment 1.

Script text

Timetocheckwhatyouhavejustlearnt!

Usingthesketcher,drawthebloodflowintheheart.

Remember,thede-oxygenatedbloodgoesinfirst!



TIP:Fromtheheart,thede-oxygenatedbloodgoestothelungswhereitundergoesgas

exchangeandisoxygenatedagain.Itthenflowstotheheartandfromtheretothebody!

Screen text

Usethemarkertosketchthebloodflow.

Visual Description

Providemarkeronright.Fadeinbelowimage.

Theuserhastofirstdrawbluecolouredbloodintotheheart,thentothelungs,.From

there,theredcolourbloodgoestotheheartandthentothebody.



Feedback :WellDone!

Anotherquestion!

Intheheartshownbelow,draganddroptheaccompanyingparts.

Screen text



Dropthelabelsintotheirplaces!

Visual Description

Fadeincharacter.Showbelowimage.

Feedback:Whenuserdragscorrectlabel,say“Thatiscorrect”

Whenuserdragsincorrectlabel,say“Thatisnotcorrect”andputlabelback.



Module 2: Blood Flow and Electrical System of the Heart

Script text

Inthismodule,letuslearnthebloodflowinthecirculatorysystemandtheelectrical

systemoftheheart.Bytheendofthismodule,youwillbefamiliarwith:

Thecirculatorysystemanditscomponents.

Thebloodflowinthesystem

Theelectricalsystemoftheheart

Visual Description

Fadeinthecharacter.OntheLCDscreenputthebulletedtext.

Frame 001

Script text



Themaincomponentsofthehumancirculatorysystemaretheheart,theblood,andthe

bloodvessels.Thebody'scirculatorysystemreallyhasthreedistinctparts:pulmonary

circulation,coronarycirculation,andsystemiccirculation.

Visual Description

Don’tlabeltheimage.

Frame 002

Thecoronarycirculatorysystemprovidesabloodsupplytotheheart.

Pulmonarycirculationtransportsoxygen-depletedbloodawayfromtheheart,tothe

lungs,andreturnsoxygenatedbloodbacktotheheart.

Theheartpumpsoxygenatedbloodtothebodyanddeoxygenatedbloodtothelungs.



Systemiccirculationcarriesoxygenatedbloodawayfromtheheart,tothebody,and

returnsdeoxygenatedbloodbacktotheheart.

Visual Description

CORONARY CIRCULATORY SYSTEM



PULMONARY CIRCULATORY SYSTEM



SYSTEMIC CIRCULATORY SYSTEM -donotlabel.

Frame 003

Script text

Letusnowlearntheelectricalsystemoftheheartwhichcontrolsthetaskofgenerating

heartbeatsAgroupofcellsgenerateelectricalactivityontheirown.Thenthey

spontaneouslyleakcertainchargedparticlesintothecells.Thisproduceselectrical

impulsesinthepacemakercellswhichspreadovertheheart,causingittocontract.

Thesecellsdothismorethanoncepersecondtoproduceanormalheartbeatof72

beatsperminute.Thesinoatrialnodeistheimpulsegenerating(pacemaker)tissue.

Visual Description

Fadeincharacter.Onthescreenshowheartwithsinoatrialnodelabeled.

Don’tlabelothers.Don’tshowthepathfornow.Onlyheartandsinoatrial.



Frame 004

Script text

Alloftheheart'scellspossesstheabilitytogeneratetheelectricalimpulsesthattrigger

cardiaccontraction,butonlythesinoatrialnodeactuallyinitiatesit.Thisisbecausethe

sinoatrialnodehastheabilitytogeneratefastpulses.



Screen text to be repeated in Audio

Letuslearntheelectricalsystemworks:

Theelectricalimpulseleavesthesinoatrialnodeandtravelstotherightandleftatria,

causingthemtocontracttogether.

Thereisanaturaldelaytoallowtheatriatocontractandtheventriclestofillupwith

blood.

Theelectricalimpulsetravelstotheatrioventricularnodewhereitstopsforaveryshort

period.

Then,itcontinuesdownthepathwaysviatheBundleofHisintotheventricles.

TheBundleofHisdividesintorightandleftpathwaystoprovideelectricalstimulationto

bothventricles.

TheElectricalsignaltravelsthroughthePurkinjefiberstothemusclesoftherightand

leftventricle,causingthemtocontractatthesametime.

Visual Description

Fadeincharacter. Onscreen,fadeinbelowfigure.Asperscreentext,in

synchronization,labeltheelements.



Frame 005

Script text

Theactivityoftheelectricalsystemgenerateselectricalwaves.Thesumofthese

electriceventscanbemeasured.Themeasurementofthewavesisdisplayedasa

graphcalledanelectrocardiogramorECG.Eachpartofwaveoftheheartbeathasa

letteredname.Letusconsideronebeatcycle.ThesequenceisorganisedintoPwave,

QRScomplexandTwave.

Visual Description



Scree n text

LetusstudytheECGindetail.

1.Pwave-coincideswiththespreadofelectricalactivityovertheatriaandthe

beginningofitscontraction.

2.QRScomplex-coincideswiththespreadofelectricalactivityovertheventriclesand

thebeginningofitscontraction.

3.Twave-coincideswiththerecoveryphaseoftheventricles.

Visual Description



Fadeinscreen.Displaybulletpointsandgraph.



Frame 006 Assess

Script text

Timetocheckwhatyouhavejustlearnt!Tracethepathoftheelectricalimpulseinthe

heart.Theimpulseisgeneratedatthesinoatrialnode.

TIP: ThepathoftheelectricalimpulseisSAnode>>AVNode>>BundleofHis>>

RightbundleandLeftbundle>>Purkinjefibres.

Screen text

Usethemarkertosketchtheimpulsepath.



Script text

Anotherquestion!Intheheartshownbelow,draganddroptheaccompanyingparts.

Screen text

Dropthelabelsintotheirplaces!

Visual Description

Fadeincharacter.Showbelowimage.



Feedback:Whenuserdragscorrectlabel,say“Thatiscorrect”

Whenuserdragsincorrectlabel,say“Thatisnotcorrect”andputlabelback.

Script text

Concludingquestion!Selecttheappropriateoption.

Screen text



OnanECG,thePwaverepresents:

A:Therepolarisationoftheventricles.

B:Thecontractionoftheventricles

C:Thecontractionoftheatria.

Feedback:

Ifuserclicksincorrectoption,say“Incorrect.Tryagain”

Ifuserclickscorrectoption,sa y“Correct”

Correctoption:C



Module 3: Introduction to Heart Rhythm Disorders

Script text

Inthismodule,letuslearnaboutheartrhythmdisorders.Bytheendofthismoduleyou

willbefamiliarwith:

CardiacArrhythmia

MechanismsofCardiacArrhythmia

Visual Description

Fadeincharacter.Onthescreenfadetheheart.Thewavemustbefastand

accompaniedbythebeepsound.

Beepsoundisat\\Chetanningoo\transfer\Stroke ECGBeepingSound

http://chetanningoo/transfer/Stroke






Frame 001

Script text

Cardiacarrhythmiaisatermforanyofagroupofconditionsinwhichthereisabnormal

electricalactivityintheheart.Theheartbeatmaybetoofastortooslow,andmaybe

regularorirregular.Thetermcardiacarrhythmiacoversaverylargenumberofvery

differentconditions.Letuslearnaboutthemindetail.

Visual Description

Fadeincharacterwithimageofheart.Sameasabove.



Frame 002

Script text

Letusclassifyarrhythmiabytheoriginoftheabnormalheartelectricalactivity.

Basedontheorigin,arrhythmiacanbedividedintofourtypes.

Script text

Atrialarrhythmia:Whenanyabnormalelectricalactivityisgeneratedintheatrial

regionoftheheart,itiscalledasatrialarrhythmia.

Ventriculararrhythmia:Whenanyabnormalelectricalactivityisgeneratedinthe

ventricularregionoftheheart,itiscalledasventriculararrhythmia.

Atrio-ventriculararrhythmia:Whenanyabnormalelectricalactivityisgenerated

betweentheatriaandventriclessomewhereotherthantheAVnode,itiscalled

asatrio-ventriculararrhythmia

Junctionalarrhythmias:Whenanyabnormalelectricalactivityisgeneratedbythe

AVnodeorinanundefinedregioninitsvicinity,itiscalledasjunctional

arrhythmias.

Visual Description

Fadeincharacter.Fadeinabovetextonscreen.



Frame 003

Script text

Letuslearnaboutthemechanismsofcardiacarrhythmia.Abnormalelectricalactivity

canbecausedbyabnormalrhythmsorincorrectimpulses.Thefollowingarethe

mechanismsofcardiacarrhythmia.Clickeachpointtoknowmore.

Screen text

Bradycardias(slowrhythm):Aslowrhythm,lessthan60beats/min,islabeledas

bradycardia.Thismaybecausedbyaslowedsignalfromthesinoatrialnode,apausein

thenormalactivityofthesinoatrialnodeorbyblockingoftheelectricalimpulseonits

wayfromtheatriatotheventricles.

Tachycardias(fastrhythm):Anyheartratefasterthan100beats/minuteislabeled

tachycardia.Tachycardiamayresultinpalpitation.Thisiscausedduetoabnormal

impulsesorbyexternalstimulantsuchascaffeine.

Automaticity(falseimpulse):Whenacardiacmusclecellfirsoffanimpulseonitsown,it

generatesafalseimpulse.Allofthecellsinthehearthavetheabilitytoinitiateanactionpotential,however,onlysomeofthesecellsaredesignedtoroutinelytriggerheartbeats.

Whenamusclewronglyfiresanimpulse,ittriggersautomaticarrhythmia.

Fibrillation(entirechamberinvolvedindisorderedelectricalimpulses):Whenan

electricalimpulserecurrentlytravelsinatightcirclewithintheheart,ratherthanmoving

fromoneendofthehearttotheotherandthenstopping,ittriggersunendingimpulses.

Suchimpulsesfurthercauseincorrectimpulsesgivingrisetomicro-reentrycircuits.

Whenanentirechamberoftheheartisinvolvedinamultiplemicro-reentrycircuits,and

thereforequiveringwithchaoticelectricalimpulses,itissaidtobeinfibrillation.

Fibrillationcanaffecttheatrium(atrialfibrillation)ortheventricle(ventricularfibrillation)

Visual Description



Frame 004 Assess

Script text


Screen text

Selectthetypeofarrhythmia.

OPTIONS:

A-Atrialarrhythmia

B-Ventriculararrhythmia:

C-Junctionalarrhythmia.

Visual Description

Fadeinimageoneatatime.Donotlabelthem.Blinktheredregion.

Image1:



Image2



Image3:



Feedback:

Image1:A,Image2:C,Image3:B.

Ifuserclicksincorrectoption,say“Incorrect.Tryagain”

Ifuserclickscorrectoption,say“Correct”

Script text

Anotherquestion!Fillintheblanks.

Screen text

Fillintheblanksbyclickinganddraggingthewordsintotheblanks.

Cardiacarrhythmiaisatermforanyofagroupofconditionsinwhichthereisabnormalelectricalactivityinthe-------.Whenanyabnormalelectricalactivityisgeneratedinthe--

-------oftheheart,itiscalledasatrialarrhythmia.Whenanyabnormalelectricalactivity

isgeneratedbytheAVnodeorinanundefinedregioninitsvicinity,itiscalledas---------

--arrhythmias.Anyheartratefasterthan100beats/minuteislabeled---------.

A:tachycardia; B:heart; C:atrial; D:junctional

Visual Description

Usermustdraganddropcorrectanswer.

Ifincorrectanswerisdragged,say“Incorrect.TryAgain”

Ifcorrectanswerisclicked,say“Correct”



Cardiacarrhythmiaisatermforanyofagroupofconditionsinwhichthereisabnormal

electricalactivityintheheart.Whenanyabnormalelectricalactivityisgeneratedinthe

atrialoftheheart,itiscalledasatrialarrhythmia.Whenanyabnormalelectricalactivityis

generatedbytheAVnodeorinanundefinedregioninitsvicinity,itiscalledasjunctional

arrhythmias.Anyheartratefasterthan100beats/minuteislabeledtachycardia.

Module 4: Summary and Assessment analysis

Script text

Letussummarisewhatwehavelearnttillnow.

Screen text

Wehavelearnt:

Importanceoftheheartinthehumanbody.



DetailedAnatomyofthehumanheart.

Thecirculatorysystemanditscomponents.

Thebloodflowinthesystem

Theelectricalsystemoftheheart

CardiacArrhythmia

MechanismsofCardiacArrhythmia

LMSwillcalculateAssessment

Visual Description

Fadeincharacterandthenthescreentext.

Module 5: Introduction to Atrial fibrillation or Vorhofflimmern (VHF)

Script text

Inthismodule,letuslearnaboutatrialfibrillationorVHF.Bytheendofthismoduleyou

willbefamiliarwith:

BasicofVHF

CausesofVHF



Visual Description

Fadeincharacterwithimageofheart.

Frame 001

Script text

Abnormalelectricalactivitycanbecausedbyabnormalrhythmsorincorrectimpulses.

Whenanincorrectelectricalimpulserecurrentlytravelswithintheheartwithoutstopping,

ittriggersunendingimpulses.Suchrepeatimpulsescausemicro-reentrycircuits.When

anentirechamberoftheheartisinvolvedinamultiplemicro-reentrycircuits,and



thereforequiveringwithchaoticelectricalimpulses,itissaidtobeinfibrillation.When

theatrialregionisaffectedbyfibrillation,itisknownasatrialfibrillationorVHF.

Visual Description

Highlighttheatrialregion.Donotlabelanyelse.

Frame 002

Script text

Thesinoatrialnodeistheimpulsegenerating(pacemaker)tissue.Theimpulsesfrom

thesinoatrialnodestimulatethemyocardiumcausingthehearttocontract.

Thiscontractionoftheheartcausesefficientbloodsupplytothepartsofthebody.

Inatrialfibrillation,theatrialregionproducesillogicalandabnormalpulses.Thusthe

originalpulsefromthenodeisoverwhelmed.



Visual Description

Animationofnormalpulse

http://en.wikipedia.org/wiki/File:Heart_conduct_sinus.gif

Animationinatrialfibrillation

http://en.wikipedia.org/wiki/File:Heart_conduct_atrialfib.gif

Frame 003

Script text

Inatrialfibrillation,theatrialregionproducesillogicalandabnormalpulsesandcontracts

irregularlyat400to600beatsperminute.Thus,theatriumisunabletopumpbloodinto

theventricle.DuetofiltereffectofAVnode,theventricularregioncontractsat100to150

beatsperminute.Thenormalheartbeatbetween50and100beatsperminuteis

severelyimpactedbyhighatrialcontraction.

Visual Description



Usebelowimageforanimation












Frame 004

Script text

Thus,atrialchamberoftheheartisinvolvedinmultiplecircuitscausingthehearttobeat

inanirregularway.Atrialfibrillationoccursduetotheentireatrialregionbeingunder

abnormalimpulses.Longdurationsofatrialfibrillation,ifuntreatedcancausethe

sinoatrialnodetocollapse.

Visual Description

Inimage,donotshowgraph.Showsinenodein red.Showaxmarkoverthesinoatrial

node.



Frame 005 Assess

Script text

Timetocheckwhatyouhavejustlearnt!Fillintheblanks.

Screen text

Fillintheblanksbyclickinganddraggingthewordsintotheblanks.

Theatrialchamberoftheheart,ifinvolvedinmultiplecircuitscausesthehearttobeatin

an-----way.-------fibrillationoccursduetotheentireatrialregionbeingunderabnormal



impulses.Longdurationsofatrialfibrillation,ifuntreatedcancausethe----nodeto

collapse.

A:irregular; B:Atrial; C:sinoatrial;

Visual Description

Usermustdraganddropcorrectanswer.

Ifincorrectanswerisdragged,say“Incorrect.TryAgain”

Ifcorrectanswerisclicked,say“Correct”

Theatrialchamberoftheheart,ifinvolvedinmultiplecircuitscausesthehearttobeatin

anirregularway.Atrialfibrillationoccursduetotheentireatrialregionbeingunder

abnormalimpulses.Longdurationsofatrialfibrillation,ifuntreatedcancausethe

sinoatrialnodetocollapse.



Module 6

Script text

Inthismodule,letuslearnaboutatrialfibrillationorVHFindetail.Bytheendofthis

moduleyouwillbefamiliarwith:

Symptomsofatrialfibrillation

ThestatesoftheECGwaveforapersonsufferingatrialfibrillation

Kindsofatrialfibrillation

Visual Description



Fadeincharacterwithimageofheartasinmodule5.

Frame 001

Script text

Themostcommonsymptomofatrialfibrillationisirregularbeatingoftheheart.This

irregularrhythmcancausefastbeats.Thisrhythmofanomalousbeatsiscalledas

palpitations.LetusstudythiswiththehelpoftheECG.

Screen text

InaregularECGwaveform,Pwave,QRScomplexandTwavecanbefound.

Inthewaveformofapersonsufferingfromatrialfibrillation,thePwavestateisabsent.

ThewaveformrhythmbecomesfastaswellasirregularintheR-Rinterval.Thus,the

normalECGisreplacedbyafastmovingECGofvaryingamplitude.

Visual Description

Fadeincharacter.








Next,fadeouttheanimationandfadeintwoimages.



Frame 002

Script text

Letuslearnthetypesofatrialfibrillation.

Screen text

Ifafirstinstanceofpalpitationself-terminatesinlessthan7daysandanotherinstance

beginslateron,itiscalledasparoxysmalatrialfibrillation.Ifthecaseofatrialfibrillation

doesnotendinsidesevendays,itfallsinthecategoryofpersistentatrialfibrillation.

Suchaconditionrequiresmedicalaidknownascardioversion.Ifmedicalaidis

unsuccessfulandtheabnormalbeatscontinueforalongtime,itisknownaspermanent

atrialfibrillation.Thisisadangerouscondition.

Visual Description

Forparoxysmalfibrillation,showabnormalbeastfor2days.



Forpersistentfibrillation,showabnormalbeastfor2weeks

Forpermanentfibrillation,showallabnormalbeatsforthemonth.

Frame 003

Script text

Whenatrialformationoccurs,itleadstoalterationorachangeinthestructureofthe

atrialregion.Thisisknownasatrialremodeling.Letusseethetypesofremodelingthat

occurintheatrialregion.



Screen text

ElectricRemodeling – Itreducesatrialrefraction.Thiseffectisobservedwithin

thefirstincidencesofatrialfibrillation

ContractileRemodeling-Itreducesatrialcontraction.Thiseffectcanleadtochangesinthephysiologicalpropertiesoftheatrialregion.

StructuralRemodeling-Themicroscopicstructureoftissueintheatrialregionis

changedinstructuralremodeling.Thiseffectappearsmonthsafteratrial

fibrillationisdetermined.Inthis,theatrialregionundergoesdilation.

Visual Description

Fadeintext.

Frame 004 - Assess

Script text


TheP,Q,R,SandTpointsaremarked.SketchthenormalSinerhythm.

Screen text

SketchanormalSinerhythm.

Visual Description



Provideamarkeronthescreen.

Feedback:“Thatiscorrect”

Script text

Inthesecondassessment,matchthetypeofatrialfibrillationtoitsdescription.

Screen text

Matchthetypeofatrialfibrillationtoitsdescription.

Visualisation:

Fadeoptions.



Feedback:

Ifuserclicksincorrectbutton,say“Incorrect”andgivefeedback

Ifuserclickscorrectbutton,say“Correct

A:3,B:2,C:1

Script text

Inthefinalassessment,judgewhetherthestatementsaretrueornot!



Screen text

ClicktheTRUEorFALSEbutton.

1. Inthewaveformofapersonsufferingfromatrialfibrillation,theSwavestateis

absent.

2. Paroxysmalatrialfibrillationselfterminateswithinsevendays.

3. Persistentatrialfibrillationcanbetreatedwithcardioversion.

Visual Description

1:False.

2:True.

3:True


Ifuserclickscorrectbutton,say“Correct”andgivefeedback

Feedback:

1. Inthewaveformofapersonsufferingfromatrialfibrillation,thePwavestateis

absent.

2. Paroxysmalatrialfibrillationselfterminateswithinsevendays.

3. Persistentatrialfibrillationcanbetreatedwithcardioversion.



Module 7

Script text

Inthismodule,letuslearnabouttheconsequencesofatrialfibrillationorVHF.Bythe

endofthismoduleyouwillbefamiliarwith:

Effectsofatrialfibrillationonthebody.

Thromboembolismandstroke

Visual Description


Frame 001

Script text

Letuslookattheeffectsofatrialfibrillationonthebody.However,somesymptomsare

absentinoldercasesofatrialfibrillationorpermanentatrialfibrillation.

Script text

Lightheadedness

Weakness



Dizziness

Shortnessofbreath

Chestpain

Palpitations

Visual Description

Createimageasbelow.



Frame 002

Script text

Letuslearnsomeeffectsofatrialfibrillationontheheart.Atrialfibrillationgivesriseto

conditionswhereheartfailurecanoccur.Theseconditionsfurtherworsenthestateof

atrialfibrillation.Thus,atrialfibrillationandheartfailureviciouslyfeedeachother.

Screen text

Atrialfibrillationgivesrisetocellularremodelingoftheatria,lossofsynchronizationof

theAVnodeandabnormalelectricalsignalsintheR-RintervalintheECG.Thiscontributestoheartfailure.Theconditionsthatmakeheartfailurelikelygiveriseto

interstitialfibrosis,atrialdilationandchangeinatrialstructurewhichagaingiveriseto

atrialfibrillation.

Visual Description

Fadeincharacter.Onscreen,puttextandimage.



Frame 003

Script text

Letuslearntheeffectsofatrialfibrillationontheheartindetail.

Screen text

Atrialfibrillationcausesprogressivefibrosisoftheatria.Insuchascenario,the

atrialregiondevelopsexcessfibrousconnectivetissueasareactiveprocess,as

opposedtoaformationofnormalfibroustissue.Withatrialfibrosis,blood

conductionabnormalitiesaredeveloped.

Duetoatrialfibrosis,inflammationofthemyocardiumormyocarditisand

inflammationofthepericardiumorpericarditiscanhappen.

Thedilationcausedbyatrialfibrosispreventsatrialcontractionandcanresultin

stagnantbloodclot,whichiscalledathrombus.

Whentheclotiscarriedawaybybloodcirculation, itiscalledasanembolus.Iftheembolusplugsabloodvesselandpreventsbloodflow,itcauses

thromboembolism.Thepluggingofthebloodvesselbytheembolusiscalledas

ischemia.Thisisadangeroussituationastheembolushascutthebloodsupply

tothedesiredpart.

Visual Description



Fadeinimagebelow.Highlightareaoftheheartasperscreentext.



Frame 004

Script text

Whentheembolusplugsabloodvesselsupplyingbloodtothebrain,itcancausea

stroke.Duetotheclot,theaffectedareaisnotabletofunction.Thiscausesinabilityto

performthefunctionsassociatedwiththepartofthebrain.Astrokeisamedical

emergencyandcancausepermanentneurologicaldamageordeath.

Visual Description

Showanimationofclottravellingtothehead.



Frame 005

Script text

Letuslookattherelationshipbetweenatrialfibrillationandotherdiseases.

Screen Text:

Atrialfibrillationcontributestoavarietyofriskfactorsforheartfailure,whichinturn

increasetheeffectofatrialfibrillation.Theendresultofthisisheartfailurewhichleadsto

thepatient’sdeath.Thusatrialfibri llationisusuallyaprogressiveillness,whichoften

worsenswiththetimeandultimatelyleadstodeath.

Visual Description

Showimagebelow.



Frame 006 - Assess

Script text


Labeltheimage.

Screen text

Dragthetabsintheirpositions.

Visual Description

TABS:Pericarditis,Myocarditis,Atrialfibrosis,Atrialdilation,Thrombosisandischemia

Feedback:

Ifuserdragsincorrectbutton,say“Incorrect”

Ifuserdragscorrectbutton,say“Correct”



Timeforanotherassessment.



Judgewhetherthestatementsaretrueornot!

Screen text

ClicktheTRUEorFALSEbutton.

1. Inatrialfibrosis,theatrialregionlosesfibroustissue

2. Thedilationcausedbyatrialfibrosispreventsatrialcontractionandcanresultin


3. Whentheclotiscarriedawaybybloodcirculation,itiscalledasanembolus.

Visual Description

1:False.

2:True.

3:True



Inatrialfibrosis,theatrialregiondevelopsexcessfibrousconnectivetissue.

Thedilationcausedbyatrialfibrosispreventsatrialcontractionandcanresultin


Whentheclotiscarriedawaybybloodcirculation,itiscalledasanembolus.



Module 8

Script text

Inthismodule,letuslearnabouttheeffectofatrialfibrillationorVHFonthesociety.By

theendofthismodule,youwillbefamiliarwith:

Effectofatrialfibrillationonsocietalmortalityrate

Effectondoctorsandpatients

Visual Description


Frame 001

Script text



Atrialfibrillationaffectsallagegroupsofthesociety.Inparticular,thedeathratedueto

atrialfibrillationanditsconsequencesisfoundtobetwiceinthe55-94agegroups.This

hasbeenverifiedbytheFraminghamHeartStudycarriedoutover5000menand

women.Thus,atrialfibrillationraisesthemortalityrateofthesociety.

Visual Description

Frame 002

Script text

TheFraminghamHeartStudydeterminedthatpeoplesufferingfromatrialfibrillation

werelikelytosufferfromstrokeasmuchasfivetimesmorethanthosewithoutatrial

fibrillation.



Visual Description

Fadeimagebelow

Frame 003

Script text

TheFraminghamHeartStudydeterminedthatpeoplesufferingfromatrialfibrillation

fromanearlierageweremorelikelytosufferfromitsilleffectsastheygrewinage.In

thegroupsufferingfromatrialfibrillation,theriskrisesfrom1.5%for50-59year-oldon

23.5%for80-89year-old.

Visual Description

Fadeimagebelow



Frame 004

Script text

Sinceatrialfibrillationisnoteasiertotreat,itisagroundofworryforthehealthsectorin

particular.Asitraisestheriskofpatientsandiseconomicallyexpensivetotreatwith

existingmethods,atrialfibrillationisalsoacauseofagonyforthosesufferingit.Atrialfibrillationconsequentlyaffectsthequalityoflife.

Visual Description

Showheartinbetween,worrieddoctoronleftandpatientonright.



Frame 005

Script text

Letusseehowatrialfibrillationaffectsthequalityoflife.Atrialfibrillationaffectsthe

qualityoflifeinanadversemanner.

Screen text

Whencomparedwithpeoplesufferingfrommyocardialinfarction,atrialfibrillation

faresworse.

Visual Description

Showimage



Theprevalenceofatrialfibrillationriseswithage.

IntheUSofA,around5millionswouldbesufferingfromatrialfibrillation.The

loweranduppercurvesshowthelowerandhigherforecastscenarios.



AtrialfibrillationcausesmosthospitalizationsintheUSofA

TheimagebelowneedstobecheckedforYcoordinates

Atrialfibrillationandheartfailureisthecauseof66%ofhospitalizationsinthelast

twentyyearsintheUSofA.



Atrialfibrillationisexpensivetolivewithasapatientwithpermanentatrial

fibrillationcostsonaverage2372$peryear.Theremainingpatients,those

withoutrelapseofatrialfibrillation,incurredcostonaverage3385$,with1-2

relapsecost6331$andmorethan3relapsecost10312$

Frame 006

Script text

Letusbrieflyrevisehowatrialfibrillationaffectsthevalueoflife.

Screen text

Atrialfibrillationdoublesthemortalityrisk

Atrialfibrillationandheartfailureviciouslyfeedeachother.

Atrialfibrillationcanaffectthequalityoflifeunfavorably



6.8millionpatientswithAtrialfibrillationintheEUandtheUSA,thatis2.3million

Americansand4.5millionEuropeans

Onaccountofincreasinglyagingpopulation,theinstancesofatrialfibrillation

wouldrise

Visual Description

Fadeincharacterandscreentext.

Frame 007 - Assess

Script text


Selectthecorrectansweroption.

Screen text

Question : Thedeathrateinthe55-94groupduetoatrialfibrillationandits

consequencesis:

Options:

A:Thricethenormalrate

B:Twicethenormalrate

C:Fivetimesthenaturalrate



Feedback: Thedeathrateinthe55-94groupduetoatrialfibrillationandits

consequencesistwicethenormalrate



Biscorrectoption



Module 9

Script text

Inthismodule,letuslearnaboutpresentpharmacologicalrisksintreatingAtrial

fibrillationorVHFonSociety.Bytheendofthismodule,youwillbefamiliarwith:

Presentmethodsofdiagnosis

IlleffectsofpresenttreatmentsofVHF

Visual Description


Frame 001

Script text

Letuslearnaboutthemethodsofdiagnosisofatrialfibrillation.

Screen text

Electrocardiogram-Atrialfibrillationisdiagnosedonanelectrocardiogram(ECG)



Echocardiogram-Anon-invasiveechocardiogramisgenerallyperformedin

newlydiagnosedatrialfibrillation.

X-ray – AchestX-rayisperformedtocheckthepresenceofanycardiac

conditionsinthecaseofatrialfibrillation.

TransesophagealechocardiogramTTE-Atransesophagealechocardiogramis

obtainedforidentifyingbloodclotsintheheart.

Visual Description

Withcharacter,fadeinscreen-text.

Frame 002

Script text

Letuslearnaboutthemethodsoftreatmentofatrialfibrillation.

Screen text

Anticoagulation – Anticoagulationagentstrytopreventtheformationofclotsand

thustrytopreventstrokeandblockingofbloodvessels.

RateControl – Ratecontrolagentstryandcontroltherateofsinoatrialnode

impulsesandthustrytopreventtheconsequencesofatrialfibrillation

Ablation – Ablationagentstrytoobliterateapartofthedamagedtissuewithradiofrequencywaves.

Deviceimplants – Deviceareimplanted,whichreduceabnormalheartbeatsor

quiverandtrytopreventilleffectsofatrialfibrillation

Visual Description



Withcharacter,fadeinscreen-text.

Frame 003

Script text

Usually,ithasbeenobservedthatthemethodsoftreatmentofatrialfibrillation

discussedcauseundesirableeffects.Asanexample,anticoagulationagentsareknown

tobeacauseofbleedingfromthebrain.

Visual Description

Fadeincharacter.

Frame 004 - Assess

Script text


Screen text

Matchthedescriptionoftheatrialfibrillationmanagementwithitsname.



1. Preventtheformationofclots

2. Controltherateofsinoatrialnodeimpulses

3. Obliterateapartofthedamagedtissue

Options:

A:RateControlagents

B:Anticoagulationagents

C:Ablationagents

Visual Description

Answer 1:B,2:A,3:C

Ifusermatchesincorrecttab,say“Incorrect”

Ifusermatchescorrecttab,say ”Correct”



Module 10 Treating Atrial fibrillation (VHF) by Multaq (dronedarone)

Script text

Visual Description



Module 11: Summary and Assessment analysis

Letussummarisewhatwehavelearnttillnow.

Screen text

Wehavelearnt:

Causesandconsequencesofatrialfibrillation.

EffectofAtrialfibrillationonsociety

PresentpharmacologicalrisksintreatingAtrialfibrillation

TreatingAtrialfibrillationbyMultaq(dronedarone)

LMSwillcalculateAssessment

Visual Description

Fadeincharacterandthenthescreentext.

multaq hf script

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