Arrhythmias/AF Flashcards
dose reduction criteria for apixaban 5 mg bid to 2.5 mg bid
age 80+
SCr > 133 umol/L
weight < 60 kg
For patients with AF aged 65 years or older or with a
CHADS2 score 1 undergoing PCI without ACS or
high-risk features, how long should DAPT be used?
atleast 1 month upto to 12 months
who should continue taking OAC + antiplatelet after 1 year of PCI ?
If they have low risk of bleeding + high risk features for ischemic coronary outcomes
A DOAC is preferred over warfarin, but if warfarin is used, what is the target INR levels?
2.0-2.5 (lower INR end)
When an OAC is indicated in the presence of active
malignancy, which anticoagulant is preferred?
DOAC (over warfarin bc of difficulty in maintaining INR)
When is amiodarone used for rate control?
only in highly-selected patients such as the
critically ill or those with significant side effects from or contraindication to first-line agents (BB/CCB/Digoxin)
When is digoxin indicated?
RATE CONTROL- as a monotherapy in older or sedentary individuals with permanent AF; or those with side effects or contraindications to first-line
agents; or in addition to first-line agents in those who fail to achieve satisfactory symptom or heart rate control
What is the optimal trough level of digoxin in HFrEF?
0.5 to 0.9 ng/ml
(in AF its unknown)
which patient population is at highest risk for digoxin-related AEs?
females
low body weight
renal dysfunction
drugs for rate control should be titrated to an endpoint of what heart rate reading?
< 100 bpm
Because long-term antiarrhythmic therapy might
not completely suppress AF, what is the focus of rhythm control?
symptom relief, improving functional capacity
and QOL, and reducing health care utilization while balancing potential adverse drug effects
When is ablation preferred as first line therapy, rather than oral drugs?
for patients with recurrent AF in whom
long-term rhythm control is desired.
t/f: . Long-term oral antiarrhythmic therapy
should be used in patients with AF within less than a year
true
t/f: . Long-term oral antiarrhythmic therapy
should not be continued in patients when AF becomes permanent.
true
