Sandbox/Recurrent AF
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2]
Recurrent Atrial Fibrillation
Shown below is an algorithm depicting the management of patients with recurrent atrial fibrillation based on the 2014 ACCF/AHA/HRS Guideline for the Management of Patients With Atrial Fibrillation.[1]
Abbreviations: AF: Atrial fibrillation; bpm: Beats per minute; DC: Direct current; EF: Ejection fraction; HR: Heart rate
Recurrent atrial fibrillation | |||||||||||||||||||||||||||||||||||||||||||||
| Asymptomatic | Symptomatic | ||||||||||||||||||||||||||||||||||||||||||||
❑ Identify the underlying etiology and treat accordingly ❑ Proceed with rate control strategy as shown below | ❑ Identify the underlying etiology and treat accordingly ❑ Proceed with rate control strategy as shown below | ||||||||||||||||||||||||||||||||||||||||||||
| Yes | No | No | Yes | ||||||||||||||||||||||||||||||||||||||||||
❑ Initiate long term rate control strategy ❑ Proceed with anticoagulation strategy as shown below | ❑ Proceed with the cardioversion strategy | ❑ Proceed with the cardioversion strategy | ❑ Initiate antiarrhythmic drug therapy for maintenance of sinus rhythm ❑ Proceed with anticoagulation strategy as shown below | ||||||||||||||||||||||||||||||||||||||||||
| Successful (sinus rhythm) | Unsuccessful (AF) | ||||||||||||||||||||||||||||||||||||||||||||
❑ Initiate antiarrhythmic drug therapy for maintenance of sinus rhythm ❑ Proceed with anticoagulation strategy as shown below | ❑ Initiate long term rate control strategy ❑ Proceed with anticoagulation strategy as shown below ❑ Consider catheter ablation | ||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ January CT, Wann LS, Alpert JS, Calkins H, Cleveland JC, Cigarroa JE; et al. (2014). "2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society". J Am Coll Cardiol. doi:10.1016/j.jacc.2014.03.021. PMID 24685668.