]> 2026-07-31T14:08:23+00:00 WBR0994 0 en Intravenous Diltiazem drip Aspirin and follow up in the office Incorrect Stable patients should have their ventricular rate controlled first. Aspirin is used more with alone fibrillation to prevent stroke, but oral anticoagulants are recommended in paroxysmal atrial fibrillation. Oral Amiodarone and follow up in the office Incorrect Amiodarone is the recommended first line antiarrhythmic drug to maintain the normal sinus rhythm after being controlled in ED first. Reassurance and follow up in the office Incorrect This patient needs to have rate control medications and further evaluation. Refer the patient to a Cardiologist This patient should be managed in ED. Intravenous rate control medications should be administered in ED such as beta blockers, calcium channel blockers (diltiazem), or digoxin. Emergency Room A 56 year-old female comes to ED complaining of sudden onset of dizziness and palpitation, and light headedness. These symptoms have been occurring frequently for the past 2 days, last for few minutes, and resolve spontaneously. She has a history of hypertension, and ischemic heart disease. Her current medications are daily aspirin, metoprolol, and hydrochlorothiazide. On examination, her heart rate is 110 bpm and shows irregular irregularity, blood pressure is 130/80 mmHg, temperature is 37 C (98.6 F), and respiratory rate is 18/min. Her EKG shows atrial fibrillation. What is the best next step in the management of this patient? A Cardiovascular 2020-10-28T02:18:34Z 2459150.5962269 WBR0994