Atrial Fibrillation Rate vs Rhythm Control Algorithm

Atrial Fibrillation Rate vs Rhythm Control Algorithm

Atrial Fibrillation Rate vs Rhythm Control Algorithm

Note: This document provides a structured summary of the Atrial Fibrillation Rate vs Rhythm Control Algorithm for educational and reference purposes. It is not a substitute for certified ACLS training and adherence to the latest guidelines published by the American Heart Association (AHA) or other relevant governing bodies. Always consult the most current official guidelines.

1. Identify Atrial Fibrillation

Irregularly irregular rhythm, no distinct P waves on ECG.

2. Assess for Instability

Look for hypotension, altered mental status, shock, chest pain, heart failure related to fast rate.

YES (Unstable) – 3. Immediate Synchronized Cardioversion

Prepare for cardioversion, sedation. Energy levels vary (usually start higher for A-fib).

NO (Stable) – 4. Rate Control vs. Rhythm Control Decision

Consider symptoms, duration of A-fib, structural heart disease, patient preference.

Rate Control Strategy

Medications: Beta-blockers, Calcium Channel Blockers (non-dihydropyridine). Digoxin (if heart failure).

Rhythm Control Strategy

Pharmacologic or electrical cardioversion. Antiarrhythmic medications (Amiodarone, Dofetilide, Sotalol, etc.). Catheter ablation.

6. Assess Stroke Risk (CHA$_2$DS$_2$-VASc) & Anticoagulation

Calculate score. Initiate anticoagulation based on risk (NOACs preferred over Warfarin for most).

7. Identify and Treat Reversible Causes & Comorbidities

Thyroid dysfunction, alcohol, infection, sleep apnea, heart failure, hypertension.

8. Ongoing Management & Follow-up

Monitor rhythm/rate, adjust medications, manage risk factors, patient education.

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