INTRODUCTION
DR REYNOLDS: Mrs B is a 60-year-old retired teacher with atrial fibrillation (AF). She is married and has 2 daughters. She lives near Boston and has commercial health insurance.
In December 2000, Mrs B experienced several self-limited episodes of palpitations and throat tightness. A stress test was negative for anginal symptoms or ischemic electrocardiogram changes at a high workload; a thyroid-stimulating hormone test was within normal limits. In May 2001, she experienced a severe episode of palpitations and was sent to a local emergency department where she was found to be in AF with a moderate ventricular response. She was treated with intravenous diltiazem and spontaneously converted to sinus rhythm. She was referred to a cardiologist, who recommended aspirin and use of a 
-blocker as needed to control palpitations. An echocardiogram showed a mildly enlarged left atrium, but was otherwise normal. A Holter . . . [Full Text of this Article]
MRS B: HER VIEW
DR P: HER VIEW
AT THE CROSSROADS: QUESTIONS FOR DR SINGER
Definition and Epidemiology
Risk Factors for Developing AF
Classification of AF
Clinical Course of AF
Risks and Benefits of Anticoagulation in AF
Optimal Intensity of Anticoagulation in AF
Who Should Receive Anticoagulant Therapy?
The Anticoagulation Decision
Anticoagulation Management
Cardioversion
The Future
Recommendations for Mrs B
QUESTIONS AND DISCUSSION
