Chronic Atrial Fibrillation
Is goal rhythm or rate control?
- B-block (EMP or EMAC) or NDHP Ca-block (VD)
- 3rd line digoxin
- HR goal is 60-80 @rest; 90-115 duringexertion
When should I anticoagulate?
- Anticoag if CHADS2 >/=2 to INR of 2-3
- EXCEPTIONS: RHD, prosthe valves, persistent thrombus or h/o thromboembo (then goal will be 2.5-3.5)
- CHAD 1 – ASA or warfarin CHAD 0 (lone AF) – ASA or no Tx
- Admit to telemetry
- Diagnostics: EKG, Echo, TSH, PT/INR, LE doppler, serum digoxin levels
- Therapeutics: anticoagation, rate control, antiarrhytymic drugs
- Other considerations: EP consult for ablation