Question

A 29-year-old with nonvalvular AF presents to the ED with palpitations, HR 148/min, BP 122/76. ECG: AF with RVR. Symptoms began 12 hours ago; he is hemodynamically stable and has no heart failure. What is the preferred initial management?

Accepted Answer

IV diltiazem for rate control

Answer

Synchronized cardioversion without sedation

Answer

Start amiodarone infusion for rhythm control first-line

Answer

Immediate transesophageal echo and cardioversion in all cases <48 h

Answer

Adenosine IV bolus

Practice question

A 29-year-old with nonvalvular AF presents to the ED with palpitations, HR 148/min, BP 122/76. ECG: AF with RVR. Symptoms began 12 hours ago; he is hemodynamically stable and has no heart failure. What is the preferred initial management?