Question

A 78-year-old man with hypertension and type 2 diabetes presents with palpitations and breathlessness. ECG shows new-onset atrial fibrillation with a ventricular rate of 130 beats per minute. He is haemodynamically stable. His CHA2DS2-VASc score is 4. What is the most appropriate initial management strategy?

Accepted Answer

Start a beta-blocker for rate control and commence long-term anticoagulation

Answer

Immediate electrical cardioversion without rate control or anticoagulation

Answer

Start aspirin monotherapy and arrange outpatient cardiology review

Answer

Start verapamil and avoid anticoagulation due to age

Answer

Provide reassurance and no specific treatment is required for rate or stroke prevention

Practice question