Most available data on atrial fibrillation pertains to chronic outpatient management or atrial fibrillation following cardiac surgery. This data may not apply perfectly to most critically ill patients. Extrapolation of available data to the management of critically ill patient is challenging, with much left to clinical judgement.
-
The IBCC chapter is located 👉 here.
- The podcast & comments are below.
Follow us on iTunes
Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
Latest posts by Josh Farkas (see all)
- IBCC – Acute Liver Failure - March 8, 2021
- IBCC – Spontaneous Bacterial Peritonitis - March 6, 2021
- IBCC – Invasive candidiasis - March 1, 2021
Hi Josh,
This is such a great addition, and very welcome.
My question relates to the utility of verapamil as the UK has no IV diltiazem.
I’ve only used it in the haemodynamically robust, well, ED-based patient. Have you used it in lieu of diltiazem in the critically ill?
I would be interested in other readers experience of this drug and its use in this population – I tend to pre-treat with calcium to ameliorate any haemodynamic perturbations from this medication.
This is such an intresting articles to read,
am really impressed
Lets say you think DC cardioversion is indicated. What voltage would you recommend (say their old vs young etc) and what do you usually pre-sedate them with if they’re awake? Thanks
Great article, but wanted to mention verapamil – my go to drug for tachycardia. I don’t have diltiazem maybe that’s better since diltiazem is less cardiac specific and is a vasodilator. That might explain hyptoension seen in studies. Verapamil is mostly cardiac specific and rarely decreases BP (you can try to prevent that by pretreating with some calcium). In my experience verapamil reduces heart rate faster and more potently than metoprolol. Often have given metoprolol 15mg i/v without any major effect, but verapamil usually works after 5mg (with flutter I often need 5-10mg to reduce AV conduction to 3:1). Would… Read more »