skip to main content

Atrial fibrillation requiring cardioversion — RCPSC IM MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCardiologyAtrial fibrillation requiring cardioversionRCPSC IM

A 59-year-old woman presents with palpitations and exertional dyspnea that began 48-72 hours ago. ECG shows atrial fibrillation at 148/min. Blood pressure is 118/74 mmHg, oxygen saturation is 97%, and there is no chest pain or pulmonary edema. She has hypertension and diabetes, and is not taking anticoagulation. What is the most appropriate investigation?

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

Reveal the answer and explanation

Correct answer: D — Transesophageal echocardiography before cardioversion if early rhythm control is pursued

For atrial fibrillation of uncertain duration or more than 48 hours, TEE can exclude atrial thrombus when early cardioversion is needed; anticoagulation is also required based on stroke risk.

Reference: CCS/CHRS atrial fibrillation guideline