Question

A 57-year-old man presents to the emergency department with acute onset palpitations and mild dyspnoea of 6 hours' duration. ECG shows atrial fibrillation with a ventricular rate of 140 beats/min. He has no heart failure, no hypotension, and no history of stroke. According to the 2021 CAEP acute atrial fibrillation best practices, what is an appropriate management strategy?

Accepted Answer

Electrical or pharmacologic cardioversion can be offered given symptom onset within 48 hours and low stroke risk, with consideration of short-term anticoagulation

Answer

Avoid cardioversion in all atrial fibrillation and use rate control only

Answer

Delay cardioversion until transoesophageal echocardiography is performed in all cases

Answer

Discharge without treatment because symptoms are mild

Answer

Start long-term dual antiplatelet therapy without anticoagulation

Practice question