In 2010, a 29-year-old man walked into a New York emergency department with a racing, irregular heartbeat. He was in atrial fibrillation at 140 beats per minute, and staff were preparing him for cardioversion. Before starting the blood thinner, a doctor performed a routine digital rectal exam to check for gastrointestinal bleeding. His heart rate dropped to 80 and his rhythm converted to normal.
That case has been cited for years as a curiosity, though the author could not fully exclude a beta blocker given minutes earlier. Now it has turned up as a footnote in something considerably more systematic: a survey that asked hundreds of atrial fibrillation patients what they actually do at home when an episode starts.
