A 32-year-old woman who received a diagnosis of peripartum cardiomyopathy (New York Heart Association class II) aft er the birth of her second child presents with symptomatic paroxysmal atrial fi...

A 32-year-old woman who received a diagnosis of peripartum cardiomyopathy (New York Heart Association class II) aft er the birth of her second child presents with symptomatic paroxysmal atrial fi brillation (AF). Typically, she experiences approximately 4 episodes of AF per year, each lasting 2 to 4 hours. During episodes, she notes palpitations, shortness of breath, and fatigue, with heart rates around 90 beats per minute, but she is able to continue working in her home. Although she has generally done well from a heart failure (HF) standpoint, she was hospitalized 3 weeks ago with acute decompensated HF. Current medications include carvedilol 25 mg twice daily, lisinopril 20 mg daily, furosemide 40 mg daily, and digoxin 0.125 mg daily. Physical examination and diagnostic study fi ndings were as follows: heart rate 60 beats per minute (regular rhythm), blood pressure 100/70 mm Hg, jugular pressure not elevated, and lungs clear; electrocardiography showed normal sinus rhythm and left bundle branch block. Which of the following would you recommend at this time? a. Add sotalol. b. Add dronedarone. c. Refer for catheter ablation. d. Continue the current regimen.