Guidelines: 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure – Question #24 With Dr. Ileana Pina

By CardioNerds - Last Updated: December 6, 2023

The following question refers to Section 10.2 of the 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure.

The CardioNerds correspondents Shivani Reddy and Dr. Dinu Balanescu answer the following heart failure-related question with Dr. Ileana Pina, of Thomas Jefferson University:

Mr. E. Regular is a 61-year-old man with a history of HFrEF due to nonischemic cardiomyopathy (latest LVEF 40% after >3 months of optimized GDMT) and persistent atrial fibrillation (AFib). He has no other medical history. Mr. Regular has been prescribed metoprolol and apixaban and has also undergone multiple electrical cardioversions and catheter ablations for AFib. He remains symptomatic with poorly controlled rates. His blood pressure is 105/65 mm Hg, and his HbA1c is 5.4%. Which of the following next steps is a reasonable approach to managing his AFib?
A Antiarrhythmic drug therapy with amiodarone. Stop apixaban.
B Repeat catheter ablation for AFib. Stop apixaban.
C AV nodal ablation and RV pacing. Shared decision-making regarding anticoagulation.
D AV nodal ablation and CRT device. Shared decision-making regarding anticoagulation.

This question refers to Section 10.2 of the 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure. Listen to the episode to hear the correct answer.

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