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Five Steps to Assess Atrial Fibrillation with Rapid Ventricular Response - #MEDSHED

Updated: Jul 1

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Five steps to assess atrial fibrillation with rapid ventricular response

 

💔 Five Steps to Assess Atrial Fibrillation with Rapid Ventricular Response - #MEDSHED



🚨 Atrial Fibrillation with rapid ventricular response can deteriorate into cardiocirculatory arrest. We need to determine if the patient is stable or unstable as hemodynamically unstable patients require immediate direct current cardioversion.



🤖 Criteria for unstable AF with RVR: AMS, hypotensive/shock, acute MI, pulmonary edema/decompensated HF.



💥 We would then determine the onset of symptoms. Ongoing AF increases the likelihood of thromboembolic risk. Has the patient been symptomatic for less than 48 hours or anticoagulated for at least 3 weeks? We can safely achieve rhythm control via direct current or chemical cardioversion with amiodarone.



📋 Patients with symptoms more than 48 hours will need rate control. The goal HR for rate control is less than 110 BPM. Rate control medications include metoprolol, esmolol, diltiazem, and digoxin. Magnesium sulfate should be given with standard rate control medications as this increases the likelihood of achieving rate control. Five steps to assess AF with RVR.



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