For example, digoxin can be used to control the heart rate in some patients with AFib or atrial flutter. In these cases, alternative medications may be used to treat stable AFib or atrial flutter. Similarly, in patients with low blood pressure or heart failure, CCBs may not be appropriate. For example, in patients with severe asthma or certain types of heart block, beta-blockers may not be safe to use. However, in some cases, AV node blocking agents may be contraindicated or not well-tolerated by the patient. These medications, such as beta-blockers or calcium channel blockers (CCBs), can help to slow down the heart rate by blocking the electrical impulses from the atria to the ventricles through the AV node. The use of AV node blocking agents is a common treatment strategy for both atrial fibrillation (AFib) and atrial flutter. Most of your questions are beyond the scope of ACLS. Q: What does the DC before the word cardioversion stand for?Ī: DC cardioversion simply means direct current cardioversion. There is the possibility of occasional wide QRS complexes due to abnormal ventricular depolarization via an accessory pathway. Q: What are atrial fibrillation and atrial flutter considered in terms of narrow or wide QRS complexes?Ī: Unless there is an underlying block the QRS complex will typically be normal/narrow. Q: To treat a patient with rapid atrial fibrillation (HR >180bpm), can calcium channel blockers be given to help control the rate?Ī: Yes, in some cases, calcium channel blockers are a good choice to help control atrial fibrillation with a rapid ventricular rate. (5.11 mb)Ĭlick for next Rhythm Review: Other Tachycardias Top Questions Asked On This Page Please allow several seconds for the video to load. The appropriate voltage for cardioverting unstable atrial fibrillation is 120-200 J.Ĭardioversion of stable atrial fibrillation should be performed with caution if the arrhythmia is more than 48 hours old and no anticoagulant therapy has been initiated due to the risk of emboli that can cause MI and stroke.īelow is a short video which will help you quickly identify atrial fibrillation on a monitor. Drugs are not used to manage unstable tachycardia. ACLS Treatments:įor the purposes of ACLS atrial fibrillation is treated when the arrhythmia/tachyarrhythmia produces hemodynamic instability and serious signs and symptoms.įor the patient with unstable tachycardia due to a tachyarrhythmia, immediate cardioversion is recommended. When the heart rate is extremely rapid, it may be difficult to determine if the rate is irregular, and the absence of p-waves will be the best indicator of atrial fibrillation. ![]() Irregular impulses that the ventricles are receiving cause the irregular heart rate. ![]() This is because there are no coordinated atrial contractions. On an ECG monitor, there are two major characteristics that will help you identify atrial fibrillation.
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