A-Fib question

[JCicco345]

A patient with a hx of AF and on digoxin or something similar. When placed on the monitor are they going to normally be in AF or sinus. I know this is a stupid question, i just have never heard the anwser to it and it was something i was wondering. Thanks in advance.

[Ridryder 911]

It depends what rhythm they are in .. there is no predictability. In fact they can be both in multiple rhythms. Example A-fib with conversion to SR or A-fib with some A-flutter. Yes, a lot of time though patent's with A-fib, have a higher degree of being in atrial fib, especially if their dig level is down.

R/r 911

[AZCEP]

If you know that a patient is on digoxin/lanoxin/digitalis/digitek, you can expect them to be experiencing any number of rhythms. When you place your patient on the monitor, and there is an abnormal rhythm present, it's reasonable to ask about their use of any of the Dig-medications. If they aren't you might have to do something. If they are, you might not be able to do anything about the problem.

[als_medic_uk]

It depends if the patient has been diagnosed with recurrent atrial fibrillation, and therefore paroxysmal or persistent. Paroxysmal atrial fibrillation, is whereby the abnormal rhythm will last for short periods [max. 1 week] and maybe become benign for a certain period, in this benign phase then the patient will have with normal sinus rhythm, after this period the atrial fibrillation will reappear again for short periods. Persistent atrial fibrillation, as it says, will last for long periods [min. 1 week], and the patient may never have a normal sinus rhythm, unless medicated, as yours is. You should also consider Lone Atrial Fibrillation. you where referring to a scenario whereby the patient was taking a cardiac glucoside, you will see NO change in the arrythmia, the AV flutter will still be present, you cannot rid it [we are talking persistent AF here] what the drug will do is increase the force of contraction, not alter the arrythmia. If the patient suffers paroxysmal AF and in sinus rhythm then a cardiac glucoside would not be used, so that scenario is out of the window [sorry pun]. So no the AF does not disappear, but the contraction improves.

Regards

hope that helps