A 32-year-old man arrives as triage level 2 with palpitations. ECG shows an irregular wide-complex tachycardia at 180/min with beat-to-beat QRS

Question

A 32-year-old man arrives as triage level 2 with palpitations. ECG shows an irregular wide-complex tachycardia at 180/min with beat-to-beat QRS variation and delta waves on a prior ECG. BP is 118/74 mm Hg and he is alert. Which of the following is the most appropriate next step in management?

Accepted Answer

IV procainamide with preparation for cardioversion if instability develops

Answer

Carotid sinus massage as definitive treatment

Answer

IV diltiazem bolus followed by infusion

Answer

IV digoxin for rate control

Answer

IV adenosine rapid push

Pre-excited atrial fibrillation — ABEM Board MCQ

A 32-year-old man arrives as triage level 2 with palpitations. ECG shows an irregular wide-complex tachycardia at 180/min with beat-to-beat QRS variation and delta waves on a prior ECG. BP is 118/74 mm Hg and he is alert. Which of the following is the most appropriate next step in management?