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    Subjects/Pharmacology/Antiarrhythmics — Mechanisms and Classification
    Antiarrhythmics — Mechanisms and Classification
    hard
    pill Pharmacology

    A 68-year-old woman with chronic atrial fibrillation and a left ventricular ejection fraction of 35% is admitted with acute decompensated heart failure. Her heart rate is 110 bpm, and she is hypotensive (systolic BP 90 mmHg). An ECG confirms atrial fibrillation with rapid ventricular response. Intravenous diuretics and vasodilators have been initiated, but the tachycardia persists. What is the most appropriate next step in rate control?

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