Atrial Fibrillation

A 68-year-old man with hypertension and diabetes mellitus presents with palpitations and dyspnea for 2 days. On examination, pulse is irregularly irregular at 110 bpm, BP 145/92 mmHg. ECG shows absent P waves, irregular RR intervals, and a ventricular rate of 115 bpm. Troponin I is normal. Echocardiography shows normal LV function and no structural heart disease. Which of the following is the most appropriate initial management?

A 62-year-old man with newly diagnosed atrial fibrillation (AF) and no structural heart disease presents to the cardiology clinic. He is haemodynamically stable, has a ventricular rate of 110 bpm, and requires rate control. Which of the following is the drug of choice for rate control in this patient?

A 58-year-old woman with permanent atrial fibrillation and a history of acute myocardial infarction 2 months ago (ejection fraction 35%) presents with persistent symptoms despite adequate rate control with metoprolol. She requires rhythm control. Which drug is the preferred choice for rhythm control in this patient?

A 62-year-old woman with newly diagnosed atrial fibrillation and no structural heart disease on echocardiogram is being evaluated for stroke risk. Which investigation is most appropriate to assess for occult left atrial thrombus before cardioversion?

A 65-year-old woman with new-onset atrial fibrillation is evaluated for anticoagulation. Her CHA₂DS₂-VASc score is 4. Which single finding best distinguishes a patient who requires anticoagulation from one who does not, according to current guidelines?