Girl, 12 years, came with a 4-month history of progressive dizziness, fatigue, and headache. She had very less exercise tolerance while participating in competitive sports. She denied any palpitations, syncope, or chest pain. Cardiac examination- She had irregular rhythm of 65–150 bpm. Weight was 63.5 kg, and BP was 104/57 mmHg.
She had clear lung fields, no hepatomegaly, and no edema. Her ECG showed AF and intermittent premature ventricular contractions(Fig Attached). What to do now? We're thinking of giving Coumadin first.