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AF rate control — GPhC CRA MCQ

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HardCardiovascular TherapeuticsAF rate controlGPhC CRA

A GP asks for advice about a 73-year-old patient with persistent AF and troublesome palpitations. The patient has asthma requiring regular inhaled therapy and BP is 142/84 mmHg. The GP is considering first-line rate control. What is the most appropriate alternative?

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Correct answer: C — Consider a rate-limiting calcium-channel blocker if suitable

Beta-blockers can be useful for AF rate control but may be problematic in patients with asthma. A rate-limiting calcium-channel blocker such as diltiazem can be considered if not contraindicated, including absence of relevant heart failure. Amiodarone is generally not routine first-line rate control because of toxicity. Aspirin does not control rate, and digoxin is less effective for exercise-related symptoms.

Reference: BNF; NICE CKS