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Postoperative atrial fibrillation — USMLE Step 3 MCQ

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ModerateSurgery (Post-operative / Follow-up)Postoperative atrial fibrillationUSMLE Step 3

A 74-year-old man develops palpitations 2 days after lobectomy. ECG shows atrial fibrillation at 135/min. Blood pressure is 126/76 mm Hg, oxygen saturation is 96% on 2 L, and he has no heart failure signs. Which of the following is the most appropriate next step in management?

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Correct answer: A — Control ventricular rate and evaluate reversible triggers

Stable postoperative atrial fibrillation is managed with rate control and trigger evaluation.

Reference: ACC/AHA atrial fibrillation guideline, https://www.jacc.org/doi/10.1016/j.jacc.2023.08.017