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COPYRIGHT 2003 International Medical News Group
* Rhythm control for atrial fibrillation offers no survival advantage over rate control and may be associated with more adverse health consequences.
The Problem
A 67-year-old male presents with left-arm tingling, a rapid pulse, and dizziness. He has a history of coronary artery disease, hypertension, and diabetes. According to an ECG, he is in atrial flutter with a ventricular rate of 140. His chest x-ray is normal. He is started on anticoagulation and sent for cardioversion. He is cardioverted and a subsequent ECG shows him to be in sinus rhythm with premature supraventricular complexes. The patient returns to the hospital in atrial fibrillation 1 week after his first cardioversion. He is converted by the cardiology service. During follow-up, he wonders why he needs to go...
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