According to the AHRQ guidelines management of atrial fibrillation (Afib) or atrial flutter (AFL) is to provide a reliable approach of care across. Guidelines are as follow:
Diagnosis/Evaluation
• Assessment of signs and symptoms
• Electrocardiogram (ECG)
• Physical exam
• Laboratory test
• Imaging (chest x-ray, echocardiogram)
• Continuous telemetry monitoring
Treatment/Management
• Resuscitation and consideration of other conditions contributing to instability
• Direct current cardioversion
• Rate-controlling agents (calcium channel blockers, beta-blockers, amiodarone, digoxin)
• Electrophysiology (EP) consultation
Major Outcomes Considered
• Heart rate control
• Rhythm control
• Mortality rate
• Stroke rate
• Bleeding rate
Clinical Presentation Patients who present with the following signs and symptoms: irregular pulse, chest …show more content…
Treatment Initial treatment depends on the hemodynamic status of the patient. There is treatment for unstable and stable AF/AFL. Protocol as per AHRQ for treatment is as follows:
Unstable AF/AFL (refer to Figure 1 in the original guideline document):
• Begin resuscitation and consider other conditions contributing to instability.
• If instability due to AF/AFL - immediate direct current cardioversion.
Stable AF/AFL (refer to Figure 2 in the original guideline document):
• For emergency department (ED) patients: Screen for early cardioversion in the ED (refer to Figure 4 in the original guideline document).
• Administer rate controlling agents as indicated (refer to Table 4 in the original guideline document) – [I, B].
• Electrophysiology (EP) consult for uncontrolled rate despite adequate trial of rate controlling agents.
• Consider the appropriateness of a rhythm control strategy (refer to Table 3 in the original guideline document) – [I,
Diagnosis/Evaluation
• Assessment of signs and symptoms
• Electrocardiogram (ECG)
• Physical exam
• Laboratory test
• Imaging (chest x-ray, echocardiogram)
• Continuous telemetry monitoring
Treatment/Management
• Resuscitation and consideration of other conditions contributing to instability
• Direct current cardioversion
• Rate-controlling agents (calcium channel blockers, beta-blockers, amiodarone, digoxin)
• Electrophysiology (EP) consultation
Major Outcomes Considered
• Heart rate control
• Rhythm control
• Mortality rate
• Stroke rate
• Bleeding rate
Clinical Presentation Patients who present with the following signs and symptoms: irregular pulse, chest …show more content…
Treatment Initial treatment depends on the hemodynamic status of the patient. There is treatment for unstable and stable AF/AFL. Protocol as per AHRQ for treatment is as follows:
Unstable AF/AFL (refer to Figure 1 in the original guideline document):
• Begin resuscitation and consider other conditions contributing to instability.
• If instability due to AF/AFL - immediate direct current cardioversion.
Stable AF/AFL (refer to Figure 2 in the original guideline document):
• For emergency department (ED) patients: Screen for early cardioversion in the ED (refer to Figure 4 in the original guideline document).
• Administer rate controlling agents as indicated (refer to Table 4 in the original guideline document) – [I, B].
• Electrophysiology (EP) consult for uncontrolled rate despite adequate trial of rate controlling agents.
• Consider the appropriateness of a rhythm control strategy (refer to Table 3 in the original guideline document) – [I,