AF Treatment Protocols & Procedures 3

Question 1

Which rate-control target is generally recommended for most patients with AF according to current guidelines?

Accepted Answer

Resting HR <110 bpm

Answer

A lenient rate-control target of resting HR <110 bpm is acceptable for most AF patients and was shown to be non-inferior to strict control in the RACE II trial.

Question 2

Ibutilide IV is used for pharmacological cardioversion of AF. What potentially life-threatening side effect requires monitoring after administration?

Accepted Answer

Torsades de pointes

Answer

Ibutilide prolongs the QT interval and can precipitate polymorphic ventricular tachycardia (torsades de pointes), requiring continuous ECG monitoring after administration.

Question 3

In a hemodynamically unstable patient with rapid AF, what is the immediate treatment priority?

Accepted Answer

Synchronized DC cardioversion

Answer

Hemodynamic instability (hypotension, chest pain, altered consciousness) from rapid AF mandates immediate synchronized DC cardioversion regardless of anticoagulation status.

Question 4

Digoxin is least effective for rate control during which condition commonly encountered in AF patients?

Accepted Answer

Exercise

Answer

Digoxin controls ventricular rate primarily via vagal tone and is ineffective during exercise when sympathetic drive overrides its effect.

Question 5

A transesophageal echocardiogram (TEE) before cardioversion is performed to rule out which specific finding?

Accepted Answer

Left atrial appendage thrombus

Answer

TEE is used to exclude left atrial appendage (LAA) thrombus before cardioversion, which if present could embolize and cause stroke during rhythm restoration.

(AF) Atrial Fibrillation Certification Practice Test

(AF) Atrial Fibrillation Certification Practice Test

AF Treatment Protocols & Procedures 3