Atrial Fibrillation with RVR

Clinic A/P, adults, Hospital A/P, Adults

Atrial fibrillation with RVR, new onset, likely 2/2 to __________ (or unknown etiology)
Differential diagnosis of A-fib reviewed.
Causes of a-fib reviewed.
ECG reviewed.
Will admit the pt to telemetry bed. Cardiac monitor.
CHA2DS2-VASc score = ____
HAS-BLED score = ___
Rate control: Will acutely rate control with________. Goal rate will be < 85 bpm for symptomatic patients and <110 bpm for asymptomatic patients. For chronic rate control, will use ______.
Anticoagulation: Will start heparin drip for anticoagulation in anticipation of procedures and then switch to oral anticoagulants after procedures or when sure there won’t be any procedures.
Consult cardiologist ____ to see the pt.
Electrical or chemical cardioversion to be attempted per cards recs.
CXR reviewed
CMP reviewed (electrolytes & renal function)
CBC reviewed
F/u TSH and free T4
F/u serial Troponins
F/u Pro-BNP
TTE (transthoracic echo) ordered

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Important links

  1. Anticoagulation for Atrial Fibrillation.
  2. Diltiazem Drip
  3. Another Diltiazem drip protocol, modified from ACC
  4. Valvular AF vs. non-valvular AF.
  5. HAS-BLED score.
  6. CHA2DS2-VASc score.

 

How do you choose between IV or PO rate control?

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