Atrial Fibrillation with RVR
45.5 هزار بار بازدید -
15 سال پیش
-
Atrial Fibrillation occurs when the
Atrial Fibrillation occurs when the atrial sites depolarize simultaneously at 400-600 bpm enabling the atrium to contract but only quiver. The most common terms used with Afib less than 100 bpm is Controlled VR (ventricular respone) or SVR (slow ventricular response). If the rate is greater than 100 bpm then it is called Uncontrolled VR (ventricular response) or RVR (rapid ventricular response). If the rate goes over 150 bpm, then t'll be identified as an AVNRT (atrio-ventricular nodal reentry tachycardia) SVT (supraventricular tachycardia). It is the most common SVT diagnosed in patients.
CAUSES:
- High blood pressure
- Heart attacks
- Coronary artery disease
- Abnormal heart valves
- Heart defects you're born with (congenital)
- An overactive thyroid gland or other metabolic imbalance
- Exposure to stimulants, such as medications, caffeine, tobacco or alcohol
- Sick sinus syndrome — improper functioning of the heart's natural pacemaker
- Lung diseases
- Previous heart surgery
- Viral infections
- Stress due to pneumonia, surgery or other illnesses
- Sleep apnea
INTERVENTION: If stable
- Keep airway patent, support breathing
- Keep O2Sat 94-99%, PETCO2 35-40 mm Hg
- Start IV/IO, 12-Lead ECG, draw/send labs
- NO Adenosine!
- May give Sotolol 100 mg (1.5 mg/kg) IV over 5 minutes. Avoid if prolonged QT
- May give Metoprolol 5 mg IV over 2-5 minutes, may repeat every 5 minutes. If no history of heart disease or CHF only.
- May give Diltiazem 0.25 mg/kg IV slow over 2 minutes, may repeat every 15 minutes. Max. dose is 0.35 mg/kg.
INTERVENTION: If Unstable
- Consider sedation
- If less than 48 hours onset: administer Synchronized Cardioversion 120-200 J
- May administer B-blockers or Calcium-channel blockers (CCB)
- Administer anticoagulants
- If greater than 48 hours: give B-blockers or CCBs, anti-arrhythmics with anticoagulants only. NO cardioversion!
Other possible interventions:
- Cardiac ablation
- Anticoagulation
- Rate controllers (B-blockers, CCBs, antiarrhythmics)
- Implanted cardioverter-defibrillator
Based on AHA ACLS 2016 Guidelines
CAUSES:
- High blood pressure
- Heart attacks
- Coronary artery disease
- Abnormal heart valves
- Heart defects you're born with (congenital)
- An overactive thyroid gland or other metabolic imbalance
- Exposure to stimulants, such as medications, caffeine, tobacco or alcohol
- Sick sinus syndrome — improper functioning of the heart's natural pacemaker
- Lung diseases
- Previous heart surgery
- Viral infections
- Stress due to pneumonia, surgery or other illnesses
- Sleep apnea
INTERVENTION: If stable
- Keep airway patent, support breathing
- Keep O2Sat 94-99%, PETCO2 35-40 mm Hg
- Start IV/IO, 12-Lead ECG, draw/send labs
- NO Adenosine!
- May give Sotolol 100 mg (1.5 mg/kg) IV over 5 minutes. Avoid if prolonged QT
- May give Metoprolol 5 mg IV over 2-5 minutes, may repeat every 5 minutes. If no history of heart disease or CHF only.
- May give Diltiazem 0.25 mg/kg IV slow over 2 minutes, may repeat every 15 minutes. Max. dose is 0.35 mg/kg.
INTERVENTION: If Unstable
- Consider sedation
- If less than 48 hours onset: administer Synchronized Cardioversion 120-200 J
- May administer B-blockers or Calcium-channel blockers (CCB)
- Administer anticoagulants
- If greater than 48 hours: give B-blockers or CCBs, anti-arrhythmics with anticoagulants only. NO cardioversion!
Other possible interventions:
- Cardiac ablation
- Anticoagulation
- Rate controllers (B-blockers, CCBs, antiarrhythmics)
- Implanted cardioverter-defibrillator
Based on AHA ACLS 2016 Guidelines
15 سال پیش
در تاریخ 1388/01/30 منتشر شده
است.
45,505
بـار بازدید شده