A 29-year-old with nonvalvular AF presents to the ED with palpitations, HR 148/min, BP 122/76. ECG: AF with RVR. Symptoms began 12 hours ago; he is he...

Question

A 29-year-old with nonvalvular AF presents to the ED with palpitations, HR 148/min, BP 122/76. ECG: AF with RVR. Symptoms began 12 hours ago; he is hemodynamically stable and has no heart failure. What is the preferred initial management?

Accepted Answer

IV diltiazem for rate control

Answer

Synchronized cardioversion without sedation

Answer

Start amiodarone infusion for rhythm control first-line

Answer

Immediate transesophageal echo and cardioversion in all cases

Answer

Adenosine IV bolus

Atrial Fibrillation-Acute Rate Control — MRCEM SBA MCQ

A 29-year-old with nonvalvular AF presents to the ED with palpitations, HR 148/min, BP 122/76. ECG: AF with RVR. Symptoms began 12 hours ago; he is hemodynamically stable and has no heart failure. What is the preferred initial management?