USMLE Step 3 - Question 49

An 82 year old male with a history of hypertension presents to his primary care physician for a routine visit. He has had some generalized fatigue but attributed it to aging. His temperature is 37.0, blood pressures 110/60, heart rate 70, and respirations 20. Physical examination reveals normal lung sounds, an irregularly irregular rhythm, and no lower extremity edema. Laboratory studies including thyroid tests and a complete blood count are normal. Below is his ECG. Which of the following is the most appropriate therapy at this time?

afib-nlHR2

A. Calcium channel blocker

B. Beta-blocker

C. Digoxin

D. Coumadin

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