doyoudig
Forum Guru
Topics: 144
Posts: 613
|
#1
If given the choices of Antiarrythmic Drugs to Convert Afib/Flutter to sinus Rhthm, which would be the DOC below.
1. Procainamide
2. Amiodarone
3. Ilbutilide
4. Soltalol,
5. Quinidine
6.Propenafone
7. Dofetilide
See Example
A 65-year old man with long-standing hypertension
presents to the emergency room complaining of palpitations.
The patient is found to be in atrial fibrillation,
and verapamil is administered to slow his ventricular rate.
The patient spontaneously converts to normal sinus
rhythm. A workup for cardiac ischemia and hyperthyroidism
is negative. Over the next 48 h the patient has multiple
episodes of paroxysmal atrial fibrillation. Which of the
following antiarrhythmic agents would be most successful
in treating his paroxysmal atrial fibrillation?
(A) Verapamil
(B) Sotalol
(C) Digitalis
(D) Propafenone
(E) Amiodarone
#2
Once you have taken care of the Rate in a Pt w/ Aflutter or Afib will you still go on to convert them to sinus rhyth via Antiarrhythmic Drugs or will this depend on the presence of certain Clinical Factors??
#3
Do You use TEE prior to cardioversion (Elective Drug or Electrical) t check for a Thrombus in Pts with Aflutter/Afib > 48 hrs only
If a Thrombus is found how long to you anticoagulate before and after Elective cardioversion
Do you need to 1st Anticoagulate a Pt w/ Afib/Flutter who is Hemodynamically Unstable and needs Urgent Electrical Cardioversion starting at 100 then 200 J's
or
Is Anticoagulation only indicated in Stable Pts w/ Aflutter/Afib of > 48 hrs whin need Elective Drug or Electrical Cardioversion
Hope You All can help me out in this!
Thx in Advance
|
| sprint123
Forum Guru
Topics: 129
Posts: 870
|
Hello doyoudig,
I think the answer to this question is C.Digitalis.
In a AFib patient,we must control the rate and then if symptoms persist,then control the rhythm of the patient along with anti-coagulation always.
Warfarin for 3 weeks-->Cardiovert-->Continue warfarin for 4 weeks.
I am not too sure about this 48 hours concept...Any inputs regarding this are welcome.
|
| sprint123
Forum Guru
Topics: 129
Posts: 870
|
To add on..
If AF>48 HOURS ,you could approach in two ways.
1.DO TEE -Rule oput clot--->Cardiovert
or
2.Stsrt warfarin x 4 weeks--->do cardioversion--->continue warfarin x 4 weeks
If AF < 48 hours,you don't have to anti-coagulate the patient ,since it requires 48 hours to form a clot.
Hope this helps.
|
| abusedpostdoc
Forum Junior
Topics: 7
Posts: 51
|
What does TEE stand for ?
I only would like to add that if a Pt is in an ER with a AFib/Flutter or VFib than you first stabilize the heart by giving Calcium, than you start the pharm medications. About the Cardio version - I am not an expert, so prefer not to comment.
___________________
There is no limit to what you can achieve in science as long as you don't care who takes the credit for it.
|
|
| |
| | | | |
