Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the first-line treatment for stable atrial fibrillation?

1. Calcium channel blocker

2. Digoxin

3. Beta blocker

4. Aspirin

The correct answer is: Beta blocker

For stable atrial fibrillation, the first-line treatment often involves the use of beta blockers. This class of medications works primarily by slowing down the heart rate, which is important in managing the symptoms associated with atrial fibrillation. They achieve this by blocking the effects of adrenaline on the heart, thereby reducing heart rate and contractility. This can help control palpitations and improve overall hemodynamic stability in patients who experience episodes of atrial fibrillation. Beta blockers are also beneficial in patients who may have underlying hypertension or coronary artery disease, as they provide additional cardiovascular protection. Their effectiveness in controlling ventricular rate can ease symptoms and improve the quality of life for individuals with atrial fibrillation. Other treatment options, while useful in specific scenarios, do not serve as the first-line for stable situations in the same way. Calcium channel blockers can also be used to manage heart rate but are typically not as preferred as beta blockers. Digoxin, while effective in controlling heart rate, is usually reserved for certain patients, such as those with heart failure. Aspirin is often used for stroke prevention in atrial fibrillation, but it does not address the issue of heart rate control, which is critical in stable cases. Thus, the role of beta blockers in