How to Deal With an Atrial Fibrillation Patient

The patient is mentating well. He doesn't appear to be any distress and denies chest pain. But we see that his heart rate has gone from the 80s and normal sinus rhythm up to the 140s to 170s. And that's attributable to the atrial fibrillation, we think. However, we don't see the sudden deterioration that would put him on an ACLS type of pathway that would require defibrillation. So we're thinking that this is a heart rate that over time might be causing problems. And we need to think about how to deal with it.