Prescribing Safety Assessment (PSA) Practice Exam

When is rhythm control indicated in patients with atrial fibrillation?

1. In elderly patients with multiple comorbidities

2. For young symptomatic patients within 48 hours of onset

3. For all patients on anticoagulation therapy

4. Only in chronic AF patients

The correct answer is: For young symptomatic patients within 48 hours of onset

Rhythm control in patients with atrial fibrillation is indicated primarily for young symptomatic patients within 48 hours of onset. This approach is particularly relevant for patients who are experiencing significant symptoms attributable to their atrial fibrillation and have had the condition for a short duration, as early intervention may lead to better outcomes. In this early stage, the chances of successfully restoring sinus rhythm are relatively high, and it may alleviate the symptoms more effectively than rate control alone. Additionally, this strategy is aligned with the recommendations of management guidelines, which advocate for rhythm control in symptomatic individuals who are younger and more likely to benefit from the potential of restoring normal heart rhythm. The other options do not appropriately capture the ideal candidates for rhythm control. Elderly patients with multiple comorbidities may not tolerate rhythm control treatment as well and might benefit more from a rate control strategy. Patients on anticoagulation therapy may not have a direct relation to the decision for rhythm control, as this pertains more to managing the risk of thromboembolism rather than directly influencing the rhythm control strategy. Chronic atrial fibrillation patients also typically do not benefit as much from rhythm control due to the longer duration of the condition and the potential for structural changes in the heart that make restoration of a