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Topics:
Pulmonology • Cardiology • Critical Care • Cardiac Electrophysiology • Advanced Heart Failure and Transplant • Hospital Medicine • General Hospital Medicine
What is your approach when a patient has concomitant acute decompensated heart failure and rapid atrial fibrillation?
Does your approach change depending on whether and how long the patient has been anticoagulated?
Answer from: at Academic Institution
Is the patient stable? If not stable, then I would move towards immediate cardioversion.
If stable (good BP) but poor oxygenation, then diuretic with consideration of metoprolol, digoxin, or amiodarone.
If unable to tolerate BB due to lower BP, then would lean towards amiodarone or digoxin.
Ant...
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Answer from: at Academic Institution
For patients with both acute decompensated heart failure (ADHF) and rapid atrial fibrillation (AF), further management depends on hemodynamic stability.
For unstable patients, Immediate electrical cardioversion is indicated, followed by rate or rhythm control.
If patients have new heart fail...