Atrial Fibrillation: Progress Note should include the following components
Appreciate AF definition; Also, appreciate Non-Valvular AF A fib duration of > 6 min or > 6 hr of atrial fib causes increased risk of stroke. Any duration a fib in a high risk chadvasc patient should be treated , but no data to suggest if duration < 6 min Patient with A fib and HCM are at high risk of stroke, and should be anti-coagualted even though low CHADS VaSC of 0. HCM is treated like non-valvular a fib. GI bleeding due to embolic ischemia is common. Such patients need to be on oral anticoagulation. CHAD VaSC of 1 in a women due to gender is to be disregarded. It counts if other risk factor is present. Anticoagulation In Atrial Fibrillation  Warfarin reduces the risk of stroke by 64 % NOAC vs warfarin in A fib
Dosing of Anticoagulation and Dose adjustment in Renal Failure: Rate Control: Common medications and dosing and Selection Rhythm Control - Selection of Strategy Pharmacological 
Additional Reference Important Additional Concepts in Atrial Fibrillation A Flutter. 2:1 Conduction.  A flutter: 4:1 conduction Discordant p wave polarity between V1 and Inferior leads: Hence, is a typical flutter Counterclockwise: Negative in V1 (positive in inferior leads)  Same patient with Variable conduction giving irregular heart rate  NOAC in Non-Valvular Atrial Fibrillation Case Discussion: 37 yo F is seen 1 week after C-section for 6 hrs of SOB with palpitation. Found to have A fib with RVR. HTN diagnosed in third trimester. ECHO shows LVH and LA dilatation. How would you manage this patient?
|
