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Internal Medicine

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A 49-year-old African-American male sees you for a routine health maintenance examination. His past medical history is significant for sarcoidosis. He has noticed some fatigue and shortness of breath over the last several months, but he is asymptomatic today. His vital signs are normal except for an irregular pulse. An EKG performed in the office is shown below. Which one of the following would be most appropriate at this point?

A) Observation only

B) Amiodarone (Cordarone)

C) Apixaban (Eliquis)

D) Metoprolol succinate (Toprol-XL)

E) A cardiology assessment for placement of a pacemaker

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