Management of AF

Question 1

How should a patient be managed if they are presenting with signs of haemodynamic instability?

Answer 1

Electrical cardioversion

Question 2

What is the management of haemodynamically stable patients based on?

Answer 2

How acute the AF is

Question 3

What is the management of AF in a haemodynamically stable patient < 48 hours?

Answer 3

rate or rhythm control

Question 4

What is the management of AF in a haemodynamically stable patient ≥ 48 hours or uncertain?

Answer 4

Rate control

Question 5

How long should a patient considered for long‑term rhythm control delay cardioversion?

Answer 5

Until they have been maintained on therapeutic anticoagulation for a minimum of 3 weeks

Question 6

Who shouldn’t be offered rate control for AF?

Answer 6

AF has a reversible cause
Heart failure primarily caused by AF
New‑onset atrial fibrillation (< 48 hours)
with atrial flutter whose condition is considered suitable for an ablation strategy to restore sinus rhythm
for whom a rhythm‑control strategy would be more suitable based on clinical judgement