aFIB paroxysmal, reverted


yo F w new onset paroxysmal aFIB symptomatic w SOB when in aFIB w RVR. No known underlying etiology, no h/o HF, CVA, hyperthyroidism; no symptoms of infection, unlikely MI.

In the ED we drew basic labs and assessed for infection with UA, CXR, and blood cultures as well as cardiac markers (Trop and BNP), TSH. Uncertain historical reliability w history of onset; will defer cardioversion.

CHADS VASC score:


Plan vagal maneuvers followed by 0.25mg/kg Diltiazem if aFIB w RVR recurs

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