NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

Anticoagulation strategy for AF of >48 hours or unknown duration includes:

1. Anticoagulation for 1 week before and 2 weeks after cardioversion

2. Anticoagulation for at least 3 weeks before and 4 weeks after cardioversion

3. Immediate cardioversion without anticoagulation

4. Anticoagulation for 6 weeks before and after cardioversion

The correct answer is: Anticoagulation for at least 3 weeks before and 4 weeks after cardioversion

Atrial fibrillation (AF) is a type of heart rhythm disorder that can increase the risk of blood clots and stroke. Therefore, anticoagulation therapy (using medications to prevent blood clots) is often recommended for patients with AF. This is especially important for patients with AF of >48 hours or unknown duration, as the risk of blood clots may be higher in these cases. Option A suggests anticoagulation for 1 week before and 2 weeks after cardioversion. While this may be sufficient for some patients, it may not be enough for those with longer duration of AF. It is important to cover the entire period of AF to ensure adequate protection against blood clots. Option C suggests immediate cardioversion without anticoagulation, which is generally not recommended. Without anticoagulation, there is a higher risk of blood clots forming and causing a stroke during or after cardioversion. Option D suggests anticoagulation for 6 weeks before and after cardioversion. This may be sufficient for some patients, but can be a longer duration of therapy than necessary and increase the risk of bleeding complications. The optimal duration of anticoagulation for AF before and after cardioversion is typically 3-4