Atrial Fibrillation — MRCP Part 1 MCQ

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Moderate"For hemodynamically stable AF with RVR without HFrEFAtrial FibrillationMRCP Part 1

A 35-year-old man with nonvalvular AF presents to the ED with RVR (HR 160), BP 128/76, and no HF history. Most appropriate initial rate control?

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Correct answer: A — IV metoprolol

For hemodynamically stable AF with RVR without HFrEF, beta-blockers or nondihydropyridine calcium channel blockers are first-line for rate control. Amiodarone (B) is for rhythm control or refractory cases. Digoxin (C) is slower and less effective alone. Adenosine (D) is for SVT. Cardioversion (E) is for instability or specific rhythm-control indications.

Reference: ACC/AHA/ACCP/HRS Guideline (2023): Atrial Fibrillation