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Atrial fibrillation rate control — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Atrial fibrillation rate controlUSMLE Step 3

A 69-year-old man with persistent atrial fibrillation has palpitations. Blood pressure is 132/78 mm Hg, heart rate is 118/min, EF is 55%, and he has no decompensated heart failure. He is anticoagulated. Which of the following is the most appropriate next step in management?

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Reveal the answer and explanation

Correct answer: D — Start metoprolol for rate control

Beta blockers or nondihydropyridine calcium channel blockers are used for rate control in stable atrial fibrillation with preserved systolic function.

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