By rray, 26 January, 2024 Useful if antiarrhythmic meds ineffective contraindicated not tolerated and in those w symptomatic clinically significant AFL ESC recommends ablation after 1 failed not tolerated BB tx 1
By rray, 26 January, 2024 Once converted consider catheter ablation in appropriate pts Ablation is more effective than antiarrhythmic drugs for persistent and paroxysmal AF
By rray, 26 January, 2024 Amiodarone 1st line if EF 40 5 7 mg kg or 300 mg then 1200 3000 mg IV over 24h Slow onset 8 12h AEs bradycardia hypotension QT prolongation phlebitis TdP
By rray, 26 January, 2024 If hemodynamically stable or electric can t be performed use pharmacologic cardioversion Multiple medication options
By rray, 26 January, 2024 If pt has obesity manual pressure augmentation or escalation of energy may improve success
By rray, 26 January, 2024 If initial shock unsuccessful or longer duration AF consider anterior post electrode vector orientation higher energy pre tx w antiarrhythmic drugs