A 68-year-old man on ICU has persistent atrial fibrillation with rapid ventricular response (HR 145 bpm) despite IV amiodarone loading and maintenance...

Question

A 68-year-old man on ICU has persistent atrial fibrillation with rapid ventricular response (HR 145 bpm) despite IV amiodarone loading and maintenance. He is on noradrenaline 0.15 mcg/kg/min for septic shock. His echocardiogram shows preserved LV function. IV magnesium 2 g has been given. What is the next most appropriate rate-control strategy?

Accepted Answer

DC cardioversion at 120J biphasic

Answer

IV digoxin 500 mcg loading dose

Answer

IV verapamil 5 mg

Answer

IV esmolol infusion

Answer

IV flecainide 150 mg

uk-fficm MCQ (SBA): Refractory Atrial Fibrillation