By rray, 25 January, 2024 Consider consequences of lifelong pacemaker implantation esp w respect to age and comorbidities in decision making regarding benefit
By rray, 25 January, 2024 If refractory to rate control meds and noncandidate failed rhythm control AVNA can improve sx and QOL but creates dependence on pacing
By rray, 25 January, 2024 Non DHP CCB options avoid in HFrEF nbsp nbsp diltiazem 0 25 mg kg over 2min May repeat 0 35 mg kg over 2min then 5 15 mg h continuous infusion nbsp nbsp verapamil 5 10 mg over 2min May repeat x2 then 5 mg h continuous infusion max 20 mg h
By rray, 25 January, 2024 BB options nbsp nbsp metoprolol 2 5 to 5 mg bolus over 2min up to 3 doses nbsp nbsp esmolol 500 mcg kg bolus over 1min then 50 300 mcg kg min nbsp nbsp propranolol 1 mg over 1min repeat q2min prn up to 3 doses
By rray, 25 January, 2024 If critically ill or decompensated HF and BBs CCBs infective contraindicated consider IV amiodarone
By rray, 25 January, 2024 If BBs CCBs ineffective or contraindicated consider digoxin alone or in combo w BBs CCBs
By rray, 25 January, 2024 If known mod severe LV dysfunction w or w o decompensated HF avoid non DHP CCBs