Acute management of atrial fibrillation: Part I. Rate and rhythm control.
Atrial fibrillation is the arrhythmia most commonly encountered in family practice. Serious complications can include congestive heart failure, myocardial infarction, and thromboembolism. Initial treatment is directed at controlling the ventricular rate, most often with a calcium channel blocker, a beta blocker, or digoxin. Medical or electrical cardioversion to restore sinus rhythm is the next step in patients who remain in atrial fibrillation. Heparin should be administered to hospitalized patients undergoing medical or electrical cardioversion. Anticoagulation with warfarin should be used for three weeks before elective cardioversion and continued for four weeks after cardioversion. The recommendations provided in this two-part article are consistent with guidelines published by the American Heart Association and the Agency for Healthcare Research and Quality.
King
Dana E
DE
Department of Family Medicine at the Medical University of South Carolina, Charleston 29425, USA. kingde@musc.edu
Dickerson
Lori M
LM
Sack
Jonathan L
JL
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000465:Algorithms; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004554:Electric Countershock; D004562:Electrocardiography; D006801:Humans
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers