5th May 2025

A 48-year-old man presents with 2 weeks of persistent palpitations.

A 48-year-old man presents with 2 weeks of persistent palpitations. He works as a fitness instructor and has no significant past medical or family history. There is no chest pain or breathlessness and has not been unwell recently. He drinks on occasion but does binge when he drinks, such as at a wedding he was at 4 weeks ago. He does not smoke. On examination his pulse is 135 bpm, irregular, respiratory rate 15 and BP 134/76. Chest is clear and there is no oedema. Bloods are unremarkable, CXR is clear, and an ECG shows AF at 130 bpm. What is the next best management step?

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