Case-Based Modules > Case 24

Sorry! While it's true that the patient is hypotensive (and so it's great that you thought of following the ACLS algorithm), it's important to note that the patient's heart rate is between the 110s and 120s. Generally speaking, a-fib isn't the cause for an acute hemodynamic decline unless the RVR reaches a HR of ≥ 150. (Exceptions include if they have concomitant mitral valve disease, which makes them more dependent on that atrial kick for diastolic filling.)

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