Persistent atrial fibrillation (AF) is diagnosed in a patient who has valvular disease, and the cardiologist has prescribed warfarin (Coumadin). The patient is scheduled for electrical cardioversion in 3 weeks
The patient asks the primary care nurse practitioner (NP) why the procedure is necessary. The NP should tell the patient: a. this medication prevents clots but does not alter rhythm.
b. if the medication proves effective, the procedure may be canceled.
c. there are no medications that alter the arrhythmia causing AF.
d. to ask the cardiologist if verapamil may be ordered instead of cardioversion.
A
Persistent AF lasts longer than 7 days and episodes fail to terminate on their own, but episodes can be terminated by electrical cardioversion after therapeutic warfarin therapy for 3 weeks. Warfarin does not alter AF. B-Blockers, calcium channel blockers, and digoxin are sometimes given to alter the rate. Verapamil is not an alternative to cardioversion for patients with persistent AF.
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