By switaschek, 27 May, 2020 If HF and rest/exercise HR not controlled w/ BB, CCB (in HFpEF) or digoxin (alone or combined): consider amiodarone4,5
By switaschek, 27 May, 2020 If BB/CCB failure/intolerance, use digoxin/combos:5 Digoxin controls resting HR in HFrEF. Combine BB w/ other drugs, incl digoxin; titrate to avoid bradycardia. Digoxin may be combined w/ BB or CCB, incl for HF pts (avoid CCB if HFrEF)
By switaschek, 27 May, 2020 Resting goal HR ≤80 per AHA/ACC, ≤110 per ESC (if asymptomatic w/ preserved LV systolic fxn, target HR ≤110 per AHA/ACC). Adjust to control rate during exertion
By switaschek, 27 May, 2020 BB or non-DHP CCB (diltiazem/verapamil);2 digoxin an option, per ESC. If LVEF
By switaschek, 27 May, 2020 Consider anticoagulant options2,3 based on stroke/bleed risks, renal fxn, pt preference
By switaschek, 27 May, 2020 Women w/ AF are at increased stroke risk vs men; a study concluded that women
By switaschek, 27 May, 2020 Direct oral anticoagulant (apixaban, dabigatran, rivaroxaban, edoxaban recommended over warfarin, in absence of mod-severe MS or mechanical valve)3