First-Diagnosed Atrial Fibrillation (Haemodynamically Stable): When Single-Agent Rate Control Has Not Achieved Target Heart Rate
This protocol applies to haemodynamically stable patients with newly identified atrial fibrillation in whom an initial single-agent rate-control strategy has failed to achieve the target resting heart rate.
Clinical scenario
First-diagnosed atrial fibrillation — AF that has not been diagnosed before, regardless of symptom status, temporal pattern, or duration — in a patient who is haemodynamically stable.
Previous line: failure condition
Initial rate control with a single agent did not achieve the goal of a resting heart rate below 110 b.p.m. This protocol is the structured next step following that failure.
Next step: treatment approach
The approach involves a combination rate control strategy, provided that bradycardia can be avoided. The clinical target remains a resting heart rate below 110 b.p.m. The complete regimen is available via the link below.
References
DOI: 10.1093/eurheartj/ehae176
- AF that has not been diagnosed before, regardless of symptom status, temporal pattern, or duration.
- Combination rate control therapy should be considered if a single drug does not control symptoms or heart rate in patients with AF, providing that bradycardia can be avoided, to control heart rate and reduce symptoms.
- Lenient rate control with a resting heart rate of < 110 b.p.m. should be considered as the initial target for patients with AF, with stricter control reserved for those with continuing AF-related symptoms.
View source ↗