Atrial fibrillation, part 1: Ventricular rate control and cardioversion

J. V. Jayachandran, J. E. Olgin, D. P. Zipes

Research output: Contribution to journalReview article


The primary goals of therapy for atrial fibrillation (AF) are improvement of hemodynamic status and symptoms and prevention of thromboembolism. Two treatment strategies are ventricular rate control with acceptance of chronic AF and cardioversion followed by attempted long-term maintenance of sinus rhythm. Urgent ventricular rate control can be achieved with intravenous digoxin, β-blockers, or calcium channel blockers. The same agents given orally are used for long-term rate control. Class IA, IC, and III antiarrhythmic drugs are usually effective for urgent conversion of AF to sinus rhythm. Perform direct-current cardioversion when pharmacologic conversion fails or the patient is hemodynamically unstable.

Original languageEnglish (US)
Pages (from-to)138-144
Number of pages7
JournalJournal of Critical Illness
Issue number3
StatePublished - Jan 1 1999

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Jayachandran, J. V., Olgin, J. E., & Zipes, D. P. (1999). Atrial fibrillation, part 1: Ventricular rate control and cardioversion. Journal of Critical Illness, 14(3), 138-144.