Cardiology Case Report: Multiple Days of AFib in an Older Woman

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The latest cardiology case report from Brady Pregerson, MD, features a woman in her 80s presenting with complaints of atrial fibrillation for multiple days. Can you determine the correct diagnosis?


A patient in their mid-80’s with a history of atrial fibrillation (AF) on dabigatran and metoprolol presents to the emergency department for evaluation of a 5-day history of shortness of breath, mild leg swelling and generalized weakness. She states that her Apple watch detected atrial fibrillation for the past several days but she had family visiting from out of town and was hoping that it would resolve on its own and so she tried waiting. She denies syncope, palpitations, chest pain, fever, cough or other complaints.


Vital signs are normal. The physical exam is also normal.

An ECG is done

What is the most likely rhythm in this patient?