Acute problems in the coronary care unit that do not require intervention. II. Atrial fibrillation with optimal heart rates.

Acute onset of atrial fibrillation during the early period of an MI does not require antiarrhythmic therapy if the ventricular response is not excessive and the patient is hemodynamically stable. The use of diuretics and/or unloading agents, determined by the degree of CHF, is the preferred management. Use of digitalis glycosides is potentially hazardous because of the possibility of precipitating A-V block in patients with acute A-V nodal injury.