Cardiology — MCQs

Q: What is the first-line treatment for rate control in a 60-year-old man with a history of atrial fibrillation who presents with palpitations and shortness of breath?

Beta-blockers. ***Beta-blockers*** - **Beta-blockers** are generally considered **first-line agents** for **rate control in atrial fibrillation** due to their effectiveness in reducing ventricular rate and improving symptoms [2]. - They work by blocking beta-adrenergic receptors, which **slows conduction** through the AV node [1]. *Amiodarone* - **Amiodarone** is primarily an **antiarrhythmic drug** used for rhythm control, not typically first-line for rate control. - It's reserved for cases where other rate control agents are ineffective or contraindicated, or in patients with **heart failure** where other rate controllers may be detrimental. *Digoxin* - **Digoxin** is a **less common first-line agent** for rate control in atrial fibrillation as its effects are often **suboptimal during exercise** and it has a narrow therapeutic index. - It is more effective for rate control at rest and may be considered in patients with **heart failure with reduced ejection fraction** or those who are sedentary. *Calcium channel blockers* - While **non-dihydropyridine calcium channel blockers** (e.g., verapamil, diltiazem) are effective for rate control in atrial fibrillation, **beta-blockers are often preferred as first-line** options unless contraindications exist. - They also **slow AV nodal conduction** but may have disadvantages such as **negative inotropic effects** that can be problematic in certain patients.

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Cardiology — MCQs

Cardiology — MCQs

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