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BET 4. INTRAVENOUS DILTIAZEM FOR THE CONTROL OF VENTRICULAR RATE FOR PATIENTS WITH RECENT ONSET ATRIAL FIBRILLATION AND LEFT VENTRICULAR FAILURE
| The first 150 words of the full text of this article appear below. |
Report by: Dr Richard Parris, Consultant in Emergency Medicine
Institution: Royal Bolton Hospital, Bolton, UK
Checked by: Dr Simon Clarke, Consultant in Emergency Medicine
Institution: Frimley Park Hospital, Camberley, UK
A 72-year-old woman with a past history of untreated hypertension presents with palpitations, shortness of breath and ankle swelling for the past 72 h.
Examination shows that she has atrial fibrillation with a ventricular rate of 162 bpm, a blood pressure of 146/78 mm Hg and signs of mild left ventricular failure (LVF), both clinically and on the chest x ray. ECG shows atrial fibrillation with a ventricular rate of 160 bpm and voltage criteria for left ventricular hypertrophy.
You decide that ventricular rate control is the most appropriate therapy for her. You have been told recently that the chronotropic effects of digoxin are of slow onset and amiodarone runs the risk of cardioversion. You wonder therefore whether
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