A 76-year-old man presents with palpitations and breathlessness. ECG shows atrial fibrillation with a ventricular rate of 140 beats per minute. He is ...

Question

A 76-year-old man presents with palpitations and breathlessness. ECG shows atrial fibrillation with a ventricular rate of 140 beats per minute. He is normotensive, has no chest pain, and there are no signs of heart failure. Symptoms started 3 days ago. What is the most appropriate initial management?

Accepted Answer

Rate control with a beta blocker such as Bisoprolol

Answer

Immediate DC cardioversion in the emergency department

Answer

Start Flecainide for pill-in-the-pocket rhythm control

Answer

Start long-term Amiodarone as first-line therapy

Answer

No treatment is required as AF is well tolerated

uk-plab-1 MCQ (SBA): Atrial fibrillation – rate control