In fact this evening the patient's telemetry after starting the latest amiodarone drip showed afib rvr with a rate of s, appeared to
Amiodarone can still lead to hypotension initially, especially when bolused; Afib with RVR is unlikely to be the cause of hypotension alone
If resolves, start PO of metoprolol or diltiazem, whichever broke the Afib RVR. Goal HR 110. If persistent, give amiodarone IV bolus 150mg and start amiodarone drip 1mg/min. Unstable atrial fibrillation with rapid ventricular response (unstable Afib with RVR): proceed directly to synched cardioversion; Chest Pain/Acute Coronary Syndrome
Or if you are hanging an Amiodarone drip, make Are you nervous your patient will flip into afib with RVR and you won't know what to do?
If resolves, start PO of metoprolol or diltiazem, whichever broke the Afib RVR. Goal HR 110. If persistent, give amiodarone IV bolus 150mg and start amiodarone drip 1mg/min. Unstable atrial fibrillation with rapid ventricular response (unstable Afib with RVR): proceed directly to synched cardioversion; Chest Pain/Acute Coronary Syndrome
Other symptoms of AFib with RVR may include dizziness, lack of energy, exercise intolerance and shortness of breath. If Afib with RVR goes on for too long then this may result in heart failure and of course worsening of existing heart failure. Control of the heart rate in patients with Afib with RVR often causes these symptoms to improve.
Amiodarone can still lead to hypotension initially, especially when bolused; Afib with RVR is unlikely to be the cause of hypotension alone
Comparing AFib and AFib with RVR. Though atrial fibrillation and AFib with RVR share the same irregular heartbeat, they are distinct in their manifestations. While atrial fibrillation is marked by the atria quivering or fibrillating, atrial fibrillation with rapid ventricular response is a subtype of this condition which signifies a rapid heart
What is Afib with RVR? Some cases of Afib involve atrial fibrillation with rapid ventricular response (RVR). This is when the rapid contractions of the atria
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Keep them coming 😊
BTW. Standalone CHF taking down an otherwise healty person like that??? No afib, no obesity, no alcoholism, no bundle blockage or left side failure??
Thank you for sharing this with us.