AFIB = Atrial FIBrillation.
RVR = Rapid Ventricular Rate: ventricular rate > 100 bpm.
HU = Hemodynamically Unstable: hypotension (systolic BP < 90 mm Hg) and evidence of shock (mental status changes or decreased urine output).
HS = Hemodynamically Stable: normotensive, normal mentation, no evidence of shock.
SDUR = Patient with AFIB < 48 hours (Short DURation). If unknown or doubt as to genuine duration, assume LDUR.
LDUR = Patient with AFIB > 48 hours (Long DURation) or unknown duration.
CDV = Direct current CarDioVersion.
EL-CDV = ELective CDV: There is time to plan for procedure including informed consent, monitored anesthesia care, and assessing for intracardiac thrombus. If AFIB is LDUR, obtain a transesopheageal echocardiogram prior to CDV. Abort CDV if any thrombus found and reassess after 3 weeks of anticoagulation.
EM-CDV = EMergent CDV: Performed to save the life of the patient at the risk of thromboembolism.
SAE = Search Alternate Etiology of shock: Being in AFIB with a normal ventricular rate does not cause shock.
FAIL-CDV = Patient has had CDV in past and reverted back into AFIB.
RC = Rate Control with goal of resting HR of 60–80 bpm, and < 110 bpm with mild exertion. For RVR, consider metoprolol 5 mg IV Q15 minutes (max 15 mg) or diltiazem IV bolus 0.25 mg/kg IV followed by 10 mg/hr IV infusion (titrate over the range of 5 to 15 mg/h IV for goal heart rate). For non-acute setting, consider metoprolol PO 25 to 100 mg twice daily or diltiazem 30 to 90 mg 3–4 times daily.