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A. Assessment and risk stratification 1. Is AF/AFL with rapid ventricular response a primary arrhythmia or secondary to medical causes? A. Rapid rate secondary to medical causes (usually in patients with pre-existing/permanent AF) e.g., sepsis, bleeding, PE, heart failure, ACS, etc.: • Investigate and treat underlying causes aggressively • Cardioversion may be harmful • Avoid aggressive rate control B. Primary arrhythmia, e.g., sudden onset of AF/AFL

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