Q:

A 67 year old man presents with palpitations. ECG shows an irregular rhythm and HR=140bpm. He is otherwise stable, BP=124/80mmHg. What is the most appropriate management?

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A 67 year old man presents with palpitations. ECG shows an irregular rhythm and HR=140bpm.

He is otherwise stable, BP=124/80mmHg. What is the most appropriate management?


  1. Bisoprolol
  2. ACEi
  3. Ramipril
  4. Digoxin

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The key is A. Bisoprolol. [In acute AF (<48h) if stable rate control by verapamil 40-120mg/8hourly

po or bisoprolol 2.5-5mg/d po. In chronic AF (>48h) rate control with beta-blocker or rate limiting CCB;

OHCM, 9th edition, page-124].

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