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PLAB02-073

David is a 67 year old male and attends the GP surgery for his medication review. Past medical history includes Ischaemic Heart Disease and Type 2 Diabetes which has been stable for several years. His repeat prescriptions include Metformin 1g twice daily, Gliclazide 80mg twice daily, Aspirin 75mg, Bisoprolol 2.5mg, Ramipril 5mg and Atorvastatin 80mg.

On examination he is found to have an irregularly irregular pulse with a resting heart rate of 75bpm. Blood pressure is stable and cardiovascular examination is otherwise normal. An ECG today confirms Atrial Fibrillation (AF). He denies any palpitations, dyspnoea or chest pain.

What is the next most appropriate step in his management?

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