Dabigatran
pradaxa
150mg PO BID
-CrCl less than 30: 75mgpo BID
-not use with CrCl less than 15
rivaroxaban
xarelto
20mg PO QD
- CrCl less than 50: 15mg po QD
- CrCl less than 15 do not use
apixaban
eliquis
5mg PO BID
- SCr over 1.5 PLUS either over 8yo or less than 60kg:2.5mg PO BID
edoxaban
savaysa
60mg PO QD
- do not use in CrCl over 95
- CrCl 15-50:30mg PO QD
if they have emergency symptoms
- IV heparinoid
- electrical cardioversion
emergency AF symptoms
MI or angina, flash pulmonary edema w/ hypoxia, HR over 150, BP less than 90/60
if they are stable, what do you do?
- rate control
- w/ NO hypoTN: BB or nonDHP
- HypoTN: amiodarone or digoxin
chronic rate control
- BB or nonDHP
- add digoxin
- add amiodarone
- CHADVASc score for anticoag
acute AF titrate to
resting HR less than 100bpm
chronic AF titrate
- w/out HF to HR less than 110 bpm
- w/ HF titrate to HR less than 80 BPM
amiodarone chronic regimen
200mg po QD
100mg if elderly or underweight
corfarone
- amiodarone
- class 3
- maintenance & conversion
betapace
sotalol
- class 3
- maintenance only
- CI: CrCl less than 40
- torsades
tikosyn
dofetilide
- class 3
- maintenance & conversion
- CI: CrCL less than 2
- torsades
corvert
ibutilide
- class 3
- conversion only
- CI: LVEF less than 30%
- highest risk of torsades
multaq
dronedarone
- analog of amiodarone
- option for patients w/out HF
- not iodine, so doesnt cause thyroid problems
norpace
disopyramide
- class 1a
- conversion & maintenance
- anticholinergic effects
rhythmol
propafenone
- class 1c
- conversion & maintenance
- metallic taste
- pretreat with BB or nDHP
tambocor
flecainide
- class 1c
- conversion or maintenance PRN
- pretreat w/ BB or nDHP
no structural heart disease
dronedarone flecainide propafenone sotolol - amiodarone
CAD
dofetilide
dronedarone
sotalol
- amiodarone
LVH
amiodarone
dronedarone
heart failure
amiodarone
dofetilide
