A 60yoM with h/o hypertension presents with palpitations x 24 hours. He has never had this before. In the ED, he has normal vital signs but his rhythm shows atrial fibrillation. You do blood tests including a ddimer, BMP, troponin, and a chest xray, all of which are normal. You are well read on the latest AF guidelines and decide to pharmacologically cardiovert because you do not want to sedate the patient. What medication is recommended for cardioversion of AF.
Answer: Propafenone or Flecainide are first line. Procainamide or Ibutilide can also be considered.
CCS guidelines: http://www.onlinecjc.ca/article/S0828-282X(10)00002-4/fulltext, http://www.onlinecjc.ca/article/S0828-282X(10)00015-2/fulltext
AHA guidelines: http://circ.ahajournals.org/content/123/10/e269
