Experts are still debating whether a rate control or a rhythm control strategy is best for treating uncomplicated atrial fibrillation with rapid ventricular response. If they opt for a rhythm strategy, clinicians vary as to whether they first attempt chemical control or an electrical approach for cardioversion.

In a 2019 paper in Acad Emerg Med, Scheuermeyer et al. describe a multicenter randomized trial evaluating two different methods of rhythm control in patients with uncomplicated acute atrial fibrillation. Patients either received an initial chemical control approach (with IV procainamide) or an initial electrical cardioversion approach (synchronized biphasic waveform sequence of 100J to 150J to 200J, with a maximum of three attempts).

Review “In Uncomplicated AFib, Is Electrical or Chemical Rhythm Control Best?” in ACEP Now before you answer the question.