A 23-year-old woman presents with acute onset palpitations and dyspnoea. ECG shows atrial fibrillation with a ventricular rate of 150 beats/min. She i...

Question

A 23-year-old woman presents with acute onset palpitations and dyspnoea. ECG shows atrial fibrillation with a ventricular rate of 150 beats/min. She is haemodynamically stable, has normal left ventricular function on previous echocardiogram, and symptoms started 4 hours ago. What is the most appropriate initial management?

Accepted Answer

IV beta-blocker to control rate

Answer

Start an oral beta-blocker and review in clinic in 1 week

Answer

Immediate synchronised electrical cardioversion

Answer

Start warfarin and plan elective cardioversion in 6 months

Answer

No treatment is necessary because she is young and stable

ca-mccqe1 MCQ (SBA): Atrial fibrillation with rapid ventricular response