Urgent ventricular rate control in patients with atrial fibrillation without heart failure

* Refer to UpToDate content on prevention of thromboembolism at the time of cardioversion and assessment of left atrial appendage thrombus.

¶ The optimal ventricular rate goal for patients with atrial fibrillation has not been determined. A reasonable goal is to achieve a resting rate ≤80 beats/min. In patients requiring urgent rate control, achieving optimal cardiovascular hemodynamics can be more clinically important than achieving the goal heart rate.

Δ If tolerance of beta blocker therapy is uncertain, esmolol or landiolol may be particularly helpful since these agents have short half-lives.