Core IM | Internal Medicine Podcast

#150 Rhythm Control in Afib: 5 Pearls Segment

19 snips
Apr 24, 2024
Learn about the benefits of rhythm control in atrial fibrillation, the use of electrical cardioversion, side effects of antiarrhythmics, and when catheter ablation should be considered. Explore the nuances of treating AFib patients with class III and class Ic antiarrhythmics, and understand the importance of tailoring treatment approaches to individual patient responses.
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INSIGHT

Rhythm Control First-Line

  • Early rhythm control for new AFib is now recommended.
  • The 2023 guidelines prioritize rhythm control within one year of diagnosis, contradicting older studies like AFFIRM.
INSIGHT

Sinus Rhythm and Heart Structure

  • Sinus rhythm prevents structural heart dysfunction (cardiomyopathy) in AFib.
  • Atrial fibrillation can lead to fibrosis, size changes, and electrical conduction changes.
ANECDOTE

Rapid Tachycardiomyopathy

  • A young woman's EF dropped to 35% after a few days in rapid tachycardia.
  • It returned to 55-60% within a week of being in sinus rhythm, demonstrating tachycardiomyopathy.
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