AF Treatment Protocols & Procedures 2

Question 1

Which antiarrhythmic drug is preferred for pharmacological cardioversion of AF in patients with structural heart disease?

Accepted Answer

Amiodarone

Answer

Amiodarone is preferred for cardioversion in structural heart disease because Class IC agents like flecainide and propafenone are contraindicated in that setting.

Question 2

What is the minimum duration of therapeutic anticoagulation required before elective cardioversion when AF onset is unknown or >48 hours?

Accepted Answer

3 weeks

Answer

At least 3 weeks of therapeutic anticoagulation prior to cardioversion is required when AF duration is unknown or exceeds 48 hours to minimize thromboembolic risk.

Question 3

During catheter ablation for AF, which vein(s) are the primary target for electrical isolation?

Accepted Answer

Pulmonary veins

Answer

Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for AF, as ectopic triggers originate predominantly from pulmonary vein ostia.

Question 4

A patient with paroxysmal AF and no structural heart disease is prescribed a 'pill-in-the-pocket' approach. Which medication is appropriate?

Accepted Answer

Flecainide

Answer

Flecainide (or propafenone) is used as a pill-in-the-pocket strategy for self-termination of AF in patients without structural heart disease.

Question 5

What energy range is typically used for biphasic direct current cardioversion of AF?

Accepted Answer

100–200 J

Answer

Biphasic cardioversion for AF typically uses 100–200 J as the initial energy level, with escalation if the first shock is unsuccessful.

(AF) Atrial Fibrillation Certification Practice Test

(AF) Atrial Fibrillation Certification Practice Test

AF Treatment Protocols & Procedures 2