USMLE Step 3 - Question 8

An 23 year old female with no significant past medical history presents to her primary care physician due to intermittent palpitations. She states that they occur randomly, can last for many minutes at a time, and make her dizzy. No syncope. Her blood pressure is 120/82, heart rate 72, and respirations 14. Physical examination is normal. Laboratory studies are normal including thyroid function testing. Her ECG is below. What is the most appropriate initial therapy?


A. Catheter ablation

B. Start verapamil

C. Start metoprolol

D. Start amiodarone