Cardiology  |  Atrial Fibrillation Pathway - Criteria For Rate Control Management




Cardiology

Atrial Fibrillation Pathway - Criteria For Rate Control Management

Rate control and cardiac OPD assessment

Consider rate control therapy in all patients with AF:

  • Ideally reduce heart rate to <80 beats/min.
  • In some patients this will not be easily achieved and a rate between 80 and 110 may be acceptable.
  • It may be helpful to check heart rate after gentle exercise.

Medications - all can be used alone or in combination except B blockers + verapamil:

  • B-blockers - metoprolol and atenolol.
  • Do not use sotalolĀ  due to the risk of ventricular arrhythmias.
  • Calcium channel blockers e.g. diltiazem or verapamil.
  • Digoxin - usually second line except in chronic heart failure when 1st line - has a role in sedate or hypotensive patients.


In addition to rate control, refer the following patients

  • <65 years olds.
  • Symptomatic especially dyspnoea.
  • Suspected valvular heart disease.
  • Suspected coronary artery disease.
  • Isolated and principal problem (as 10% people >80 have AF consider referral to HIA where AF is one of a number of problems in an elderly patient).


Last updated : Friday, August 21, 2015
Next review date : Saturday, August 20,2016


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