QuestionSBA
QuestionChoice
Rate-limiting calcium channel blockers (CCB) or beta-blockers are the first-line management option for rate control in patients with atrial fibrillation. Verapamil is more suitable for this patient due to her history of asthma. CCBs should be used with caution in patients with heart failure due to their negatively inotropic effects.
10006816
a
Verapamil
QuestionChoice
Atropine is a muscarinic agonist and is used in sinus bradycardia, not atrial fibrillation. It can cause atrial fibrillation and would not have a role in this patient's management.
10006819
d
Atropine
QuestionChoice
Amiodarone is effective at controlling rate and rhythm in atrial fibrillation. However, it is associated with a large number of side effects, so is typically reserved for use in older, sedentary patients.
10006820
e
Amiodarone
QuestionChoice
Beta-blockers are typically the first line option (along with CCBs) for rate control in patients with atrial fibrillation. However, it is contraindicated in this patient due to her history of asthma.
10006817
b
Bisoprolol
QuestionChoice
Digoxin can be used for rate control in some patients. However, it is not as effective as beta-blockers or calcium channel blockers. It is not effective at controlling heart rate during exertion, and is typically reserved for sedentary patients with low blood pressure or co-existent heart failure.
10006818
c
Digoxin
Concept
Chapter
2693
3714
Atrial fibrillation
Topic
134
Cardiology
13910
A 58-year-old woman presents to her GP complaining of palpitations for the last three days. She describes this as feeling like her heart is beating out of her chest and skipping occasional beats. An ECG is ordered which shows atrial fibrillation. She has a past medical history of asthma, for which she takes a salbutamol inhaler. The patient is normally fit and active, and her current observations are stable.

Which of the following medications would be most appropriate for rate control in this patient?
a