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AF Management (RATE CONTROL (B-Blockers: Atenolol or Metoprolol tartrate,…
AF Management
RATE CONTROL
- B-Blockers: Atenolol or Metoprolol tartrate
If Low LVEF --> Use HF B-Blocker (Metoprolol succinate, Bisoprolol, Carvedilol)
- If B-Blocker not tolerated or CI --> CCB (Diltiazem or Verapamil). Avoid in LVF
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RHYTHM CONTROL
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PHARMACOLOGICAL ACUTE
Flecainide 1.5 - 2mg/kg (up to 150mg) IV infusion over 10 minutes. PRFERRED in pt's WITHOUT LVF or Coronary Disease
Amiodarone 300mg IV Infusion over 1 - 2hrs, followed by 900mg IV Infusion over 24hrs. PREFERRED in pt's WITH LVF or Coronary Disease.
LONG TERM
- Flecainide + AV Node Blocker (BB, CCB)
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HAEMODYNAMICALLY STABLE
Episode Lasting < 48hrs
Low Thromboembolic Risk, consider immediate Rate OR Rhythm Control Strategy. Commence Anticoagulation and continue longer term with reassessment of risk.
Episode Lasting > 48hrs
ANTICOAGULATE. Exclude LA Thrombus (TOE). If patient has not been on Anticoagulation for 3/52 --> RATE CONTROL
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