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Atrial fibrillation stroke prevention — ABFM Board MCQ

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HardCardiovascularAtrial fibrillation stroke preventionABFM Board

A 72-year-old man has palpitations and mild dyspnea. ECG shows atrial fibrillation at 118/min. He has hypertension and prior transient ischemic attack. Creatinine clearance is 58 mL/min and hemoglobin is normal. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Oral anticoagulation with rate control strategy

CHA2DS2-VASc score is high due to age, hypertension, and prior TIA, so oral anticoagulation is indicated. Rate control is appropriate when stable; cardioversion decisions require duration and anticoagulation considerations.

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