11/13/2023 0 Comments Paroxysmal atrial fibrillation ecgRate control aims to get the heart rate below 100 and extend the time during diastole for the ventricles to fill with blood. The higher the heart rate, the less time is available for the ventricles to fill with blood, reducing the cardiac output. In patients with atrial fibrillation, the atrial contractions are not coordinated, so the ventricles must fill by suction and gravity, which is considerably less efficient. The function of the atria is to pump blood into the ventricles. If you remember one thing about the treatment of atrial fibrillation, remember this combination. Most patients will end up on a beta blocker for rate control, often bisoprolol, plus a DOAC for anticoagulation. TOM TIP: The following details on rate and rhythm control get quite detailed and complex. There are two principles to treating atrial fibrillation: Follow local and national guidelines when treating patients. Management here is based on the NICE guidelines from 2021. They recommend patients with valvular heart disease are referred to a cardiologist for further assessment and management. The NICE guidelines (2021) do not reference valvular atrial fibrillation. Atrial fibrillation without valve pathology or with other valve pathologies, such as mitral regurgitation or aortic stenosis, is classed as non-valvular AF. The assumption is that the valvular pathology has led to atrial fibrillation. Valvular atrial fibrillation is AF with significant mitral stenosis or a mechanical heart valve.
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