Ray is a 68 year old gardener who attends an emergency appointment as he has suffered with severe palpitations which he noticed yesterday morning. He is uncertain of when the symptoms started exactly and there is no associated chest pain, breathlessness or dizziness. Apart from Psoriasis, he is normally fit and well. On examination, his vital observations are normal except an irregular pulse is detected. Otherwise, cardiorespiratory examination is unremarkable. An urgent ECG performed by your colleague reveals an absence of P waves and pulse rate of 92.

What would be the best course of action?

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