Murmurs and cardiac enlargement should be sought. Peripheral bruits may be a marker for associated coronary artery disease atrial fibrillation, fibrilation, atreal, palpitations, irregular heart beat. The ventricular rate is irregularly, irregular and Laboratory evaluation. The first goals of therapy should be control of the ventricular rate. Intravenous calcium channel blockers and beta blockers have the advantage of rapid onset of action.
Digoxin has a delayed onset of action of two hours.