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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?
3 Answers
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Mednet MemberInvited Expert
Hospital Medicine · UCSD School of Medicine
Answered on
  1. Is the patient stable? If not stable, then I would move towards immediate cardioversion.
  2. If stable (good BP) but poor oxygenation, then diuretic with consideration of metoprolol, digoxin, or amiodarone.
  3. If unable to tolerate BB due to lower BP, then would lean towards amiodarone or digoxin.
  4. Anticoa...

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Mednet Member
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Hospital Medicine · Dartmouth-Hitchcock Medical Center
Answered on

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 failure, wh...

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Mednet Member
Mednet Member
Cardiology · University of Puerto Rico School of Medicine
Answered on

Transesophageal Echocardiogram (TEE) and Cardioversion (CV).

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