A 72-year-old woman has a new-onset atrial flutter with a ventricular rate of 150/min. She is hemodynamically stable with a blood pressure of 155/90 mm Hg but is experiencing palpitations. Which of the following drugs is the best intravenous choice for controlling the heart rate?
Diltiazem and verapamil may be of help in both acute paroxysms of atrial flutter and chronic management. The other choices do not affect the AV node to slow down flutter, and atropine accelerates AV conduction. At times, catheter ablation of the flutter pathway is required in chronic atrial flutter. Surgical ablation is reserved for cases where other surgical interventions are required.