Arrhythmias USMLE Step 1 Practice Question
A 79-year-old man with atrial fibrillation presents with blood pressure 148/92 mmHg, heart rate 62 bpm, respirations 16/min, and oxygen saturation 98% on room air. He has hypertension, diabetes mellitus, and prior ischemic stroke. Current medications include metoprolol and aspirin. Recent ECG confirms atrial fibrillation with controlled ventricular response. He denies chest pain or dyspnea. Which of the following represents the most important additional long-term management consideration?
Answer choices
- ARoutine prophylactic pacemaker placement
- BAnticoagulation to reduce thromboembolic stroke riskCorrect answer
- CDaily aspirin only regardless of risk
- DPermanent adenosine therapy
- EAvoid all exercise
- FRate control optimization with calcium channel blockers to achieve heart rate <50 bpm
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