76 yo man (retired teacher) with HTN, not well controlled
Presents with moderate SOB and ↑ tiredness
Found to be in AF with rates of ~100 bpm
PMHx: HTN; mild PAD (ABI 0.7)
Meds: Atenolol
PE: BP 168/92; HR 90-100 bpm
Exam unremarkable
ECG: AF; mild signs of LVH
Labs: Normal including TFTs
ECHO: Normal EF; LA size 4.3 cm, mild LVH
Stress test: Normal EF; no ischemia