23rd September 2021

A 75-year-old female is admitted after presenting with palpitations

A 75-year-old female is admitted after presenting with palpitations. She has a past medical history of asthma, for which she regularly takes inhalers, and a myocardial infarction eight years ago. An ECG shows a rate of 150 and regular QRS complexes, of the same shape, with widths greater than 0.12s. Her observations include: a pulse of 190, blood pressure of 86/50, respiratory rate of 20, and oxygen saturations of 92%. She is administered three synchronised DC shocks, which are effective at terminating her tachycardia. She subsequently feels a lot better. Blood tests reveal neither electrolyte abnormalities nor a raised troponin.

Which of the following is the most appropriate long-term management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.