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A 36-year-old man presents with the sensation of a racing heart. His blood pressure is 110/70, respiratory rate 14/min, and O2 saturation 98%. ECG is shown. Carotid massage and Valsalva maneuver do not improve the heart rate. Which of the following is the initial therapy of choice?
A. Adenosine 6-mg rapid IV bolus
B. Verapamil 2.5 to 5 mg IV over 1 to 2 minutes
C. Diltiazem 0.25-mg/kg IV over 2 minutes
D. Digoxin 0.5 mg IV slowly
E. Electrical cardioversion at 50 J
Ans A