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ILE 8 - afib treatment algorithm
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ILE 8 - afib treatment algorithm
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By: EXAMQA • 5 months ago
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ILE 8 - afib treatment algorithmafib is both a
Acute and chronic condition
fib may have rapid ventricular response which can be
life threatening with rapid HR and hemodynamic collapse
Emergency
both acute and chronic require
rate control
rate lowering meds
Rate control- leaving them in afib but slowing HR
rhythm control
restoration of sinus rythym
decision points when doing pt eval
-Cardioversion
-Rate vs rhythm
-Anti-arrhythmic
-Stroke risk
-Anticoag
acute HF can be
Can be asymptomatic, tachycardia or ic about to die, cant talk etc,
severe hypotension, pulmonary edema,
If tachycardic > 110 and symptomatic but can talk
-First goal is to reduce ventricular rate
-Then determine whether to restore rhythm
, If pt symptomatic about to die, cant talk etc, severe hypotension,
pulmonary edema,
Electric cardioversion, do not wait for anti-coagualtion
Selecting an agent for acute rate control
Beta blockers, non-DHP CCB, digoxin, amiodarone
BB and CCb
Faster
Similar efficacy
all agents for acute rate control dosed
iV initially
acute rate control agent choice based on
LV function
in acute rate control, can add on
IV magnesium
NO HF acute rate control agents
1. BB, verapamil or diltizaem- 1st choice
2. digoxin
3. amiodarone
Digoxin impacts
-resting HR but not exercise
-Goal range 0.5-1.2
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