Question

A 72-year-old woman with new-onset atrial fibrillation (AF) presents with palpitations. BP 128/78 mmHg, HR 124 bpm irregularly irregular. She has no haemodynamic instability, heart failure or ischaemia. Symptoms started 18 hours ago. What is the most appropriate immediate rhythm strategy?

Accepted Answer

Offer rate control with a beta-blocker first line

Answer

Immediate DC cardioversion without anticoagulation

Answer

Start amiodarone oral loading

Answer

Start flecainide as a pill-in-the-pocket

Answer

Perform transoesophageal echo then DC cardiovert today

Practice question

A 72-year-old woman with new-onset atrial fibrillation (AF) presents with palpitations. BP 128/78 mmHg, HR 124 bpm irregularly irregular. She has no haemodynamic instability, heart failure or ischaemia. Symptoms started 18 hours ago. What is the most appropriate immediate rhythm strategy?