76
Management
Figure 17. Acute Rate Control in AF With Rapid Ventricular
Response (RVR)
* Note: Contraindicated in patients with moderate-severe LV dysfunction regardless of
decompensated HF.
Beta blockers,
verapamil, or diltiazem
(1)
Addition of
magnesium
to AV nodal
blockade
(2a)
IV Amiodarone*
(2b)
Verapamil, diltiazem
(3: Harm)
Direct current
cardioversion (DCCV)
(1)
YES
YES
NO
NO
Hemodynamically
stable?
Decompensated
HF?
Digoxin
(2a)
Amiodarone
(2b)
7.2.2. Long-Term Rate Control
COR LOE
Recommendations
1 B-NR 1. In patients with AF, beta blockers or nondihydropyridine
calcium-channel blockers (diltiazem, verapamil) are
recommended for long-term rate control with the choice
of agent according to underlying substrate and comorbid
conditions.
2a B-NR 2. For patients with AF in whom measuring serum digoxin levels
is indicated, it is reasonable to target levels <1.2 ng/mL.
