If 48 hours the patient needs to go on warfarin for four weeks. Simply cardioverting an Afib that’s lasted > 48 hrs runs the risk of throwing an embolism (and a stroke). If the goal is rhythm control (cardioversion) it’s necessary to determine how long the Afib’s been present. But, you have to weigh risks and benefits in each patient. Rate control is just as good as rhythm control (cardioversion). In the acute setting (ACLS in a nutshell) simply decide between shock and rate control. It responds to amiodarone (newer/better) or lidocaine (older/cheaper)Ītrial Fibrillation can be identified by a narrow complex tachycardia with a chaotic background, absent p-waves, and an irregularly irregular R-R interval. Look for the “tombstones.” Since it’s ventricular there are no paves at all - just the QRS complexes. Ventricular Tachycardia is a wide complex and regular tachycardia. 12msec and means it’s a ventricular rhythm while narrow is 150 + the loss of p-waves (can you tell p-waves from twaves?).
1) Determine the rate: tachycardia is > 100, bradycardia. In order to identify the rhythm, follow these simple principles. Cardiology Step 1: General Principles The Step 2 exam will ask to either identify the rhythm or choose an intervention.
