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Recent-onset atrial fibrillation — RCPSC EM MCQ

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HardCardiovascular emergenciesRecent-onset atrial fibrillationRCPSC EM

CTAS 2. A 59-year-old with hypertension presents 5 hours after abrupt palpitations. BP is 136/82 mmHg, HR 152 irregular, SpO2 98%, and troponin is negative. He has no heart failure, no stroke history, and takes no anticoagulant. ECG shows atrial fibrillation without ischemic changes. What is the most appropriate next step?

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Correct answer: C — Offer ED rhythm control with anticoagulation planning

Stable recent-onset atrial fibrillation can be considered for ED rhythm control, with stroke-risk assessment and anticoagulation planning according to Canadian ED AF guidance.

Reference: CAEP Acute Atrial Fibrillation/Flutter Best Practices Checklist, 2021