Archief Roodbont

Which of the following interventions would be most appropriate for LD at this point?

			Your Colleagues Responded:
	Administer a beta-blocker or calcium channel blocker to restore rate control	Correct Answer	64%
	Administer digoxin, 0.5 mg orally, to improve rate control		9%
	Electrical cardioversion to restore sinus rhythm		10%
	Pharmacologic cardioversion to restore sinus rhythm		18%

Beta-blockers or nondihydropyridine calcium channel blockers are effective for controlling the ventricular rate (rate control) and are recommended by the 2010 European Society for Cardiology (ESC) guidelines. Digoxin is not recommended as a single agent for acute rate control and requires a higher loading dose, preferably intravenously. Rhythm control is probably not warranted at this point because the patient's symptoms are relatively mild (even in the absence of adequate rate control) and her episodes have been self-limiting.