11-03-2006, 07:40 PM
A physician is asked to see a 30years old woman with no medical problem except an episode of flutter for 3 years. Usually these episodes are not associated with chest pain or dizziness. Previously she had normal thyroid function test, a normal echocardiogram, and a negative excercise stress test. She denies a significant use of alchol, she does not drink coffee. Usually an episode lasts less than 24 hours . During the last 2-3months her symptoms have been more frequent and longer lasting despite taking verapamil. Her EKG during atrial flutter revealed an F wave that is negative in inferior leads and positive in the V1.
Which of the following is the most appropriate next step?
A) Start her on flecainide
B) Start her on Beta blocker
C) Refer the pt for an electrophysiologic study and radiofrequency ablation
D) Start her on Amiodarone
E) Add digoxin to her medical therapy
Which of the following is the most appropriate next step?
A) Start her on flecainide
B) Start her on Beta blocker
C) Refer the pt for an electrophysiologic study and radiofrequency ablation
D) Start her on Amiodarone
E) Add digoxin to her medical therapy