The Race Trial and Race Trial

It sounds like if you can get it less than 80 pretty easily, then you know itit almost reminds me of blood pressure. Um, so typically we're reaching for rate control first. A lot of times it's amt a or carvetaa am but am at what point, if ever, do you feel the internist should entertain duel avinotal blockade with a bata blocker and a calcium channel blocker? Or at that point should we be thinking of arhythm control strategy, or sending them on to your cardiology clinic?