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Cardioversion
Direct current delivery of an electrical shock
Pharmacologic cardioversion
Flecainide
Dofetilide
Propafenone
Ibultilide (IV)
Amiodarone
Who should be cardioverted
Hemodynamic instability: Acutely altered mental status, chest pain/MI, hypotension or signs of hypoperfusion, HF
Long term rhythm control
Symptomatic persistent atiral fibrillation
First episode
Infrequent symptomatic episodes
Potentially reversible cause
Who shouldn’t be cardioverted
Asymptomatic or minimally symptomatic
Low likelihood of successful cardioversion or maintenance of sinus rhythm
Anticoag considerations for cardioversion diagram
Antiarrythmic drug selection for pharmacologic cardioversion diagram (short term)
Antiarrythmic drug selection (long term)
Pt factors that favor rhythms control (age, AF history, sympton burden)
Younger
shorter history of AF
More symptoms
Pt factors that favor rate control (age, AF history, sympton burden)
Older
Longer history of AF
Fewer symptoms
Note
Flashcard