Question

A 69-year-old man in atrial fibrillation with a ventricular rate of 160 bpm presents with palpitations and shortness of breath for 12 hours. He is haemodynamically stable with blood pressure 126/78 mmHg, no chest pain, and no heart failure signs. What is the most appropriate initial management?

Accepted Answer

Rate control with oral Bisoprolol provided there are no contraindications

Answer

Immediate synchronised DC cardioversion in the emergency department

Answer

Start Sotalol and review in 24 hours

Answer

Start Warfarin and arrange elective cardioversion in 3 months

Answer

No treatment is required as AF is well tolerated

Practice question

A 69-year-old man in atrial fibrillation with a ventricular rate of 160 bpm presents with palpitations and shortness of breath for 12 hours. He is haemodynamically stable with blood pressure 126/78 mmHg, no chest pain, and no heart failure signs. What is the most appropriate initial management?