Question

A 68-year-old man presents with palpitations and breathlessness. ECG shows new-onset atrial fibrillation with a ventricular rate of 140 bpm. He is haemodynamically stable and symptom onset is uncertain (>48 hours cannot be excluded). What is the most appropriate initial management in primary care?

Accepted Answer

Rate control with a beta-blocker (e.g., bisoprolol)

Answer

Immediate DC cardioversion

Answer

Start amiodarone for rhythm control

Answer

Start flecainide and discharge

Answer

Urgent referral for catheter ablation

Practice question

A 68-year-old man presents with palpitations and breathlessness. ECG shows new-onset atrial fibrillation with a ventricular rate of 140 bpm. He is haemodynamically stable and symptom onset is uncertain (>48 hours cannot be excluded). What is the most appropriate initial management in primary care?