My patient has a history of Atrial Fibrillation, and converted from Normal Sinus Rhythm (regular rate) to Afib at 2200. Rate was 160 at times. The Nurse gradually titrated Cardizem up to maximum dose, and then gave the patient a bolus of Cardizem 30 minutes later. At 0115 the patient converted to Sinus Rhythm 90bpm with frequent PACs.

Now, I see a multifocal atrial activity that is not noticeable prior to the conversion. Is this worth being concerned? Can anyone shed light to this?