A 45 year-old woman with a history of palpitations develops lightheadedness and palpitations. She has received adenosine 6 mg IV for the rhythm shown above without conversion of the rhythm. She is now extremely apprehensive. BP is 108/70 mm Hg. The next appropriate intervention is:
perform vagal maneuvers and repeat adenosine 6 mg IV.
repeat adenosine 12 mg IV
Perform immediate unsynchronized defibrillation
repeat adenosine 3 mg IV
sedate and synchronized cardiovert
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