By switaschek, 28 May, 2020 Cath ablation7 for paroxysmal AF w sx useful if refractory intolerant to 1 class I III drug reasonable as initial strategy before class I III drug trial for recurrent paroxysmal AF w sx
By switaschek, 28 May, 2020 Cath ablation7 periablation anticoagulation4 is an option factor risk benefit pt preference
By switaschek, 28 May, 2020 Postconversion maintenance drug options5 based on CAD LVH HF comorbidities drug risks rate control tx OK to continue antiarrhythmic despite infrequent well tolerated recurrences8 stop if AF becomes permanent
By switaschek, 28 May, 2020 Postconversion pill-in-pocket prn option: propafenone/flecainide + BB/non-DHB-CCB (diltiazem/verapamil), once proven safe in monitored setting, reasonable to terminate out-pt AF
By switaschek, 28 May, 2020 Pharmacologic cardioversion5 6 periprocedural anticoagulation4 rate control tx flecainide dofetilide propafenone IV ibutilide or amiodarone 7 amiodarone preferred if ICVD or structural heart dz per ESC6
By switaschek, 28 May, 2020 DC cardiovert + periprocedural anticoagulation.4 Repeat/serial attempts based on sinus rhythm duration, sx, pt preference4 +/- rate-control tx
By switaschek, 27 May, 2020 Restore sinus rhythm1 via DC cardioversion antiarrhythmic drug or RF cath ablation rate control Correct underlying causes
By switaschek, 27 May, 2020 May consider LAA occlusion/exclusion if contraindication to long-term anticoagulation
By switaschek, 27 May, 2020 If PCI w/ stenting: reasonable to add clopidogrel 75 mg/day or ticagrelor (not aspirin) to anticoagulant