Abstract
Background
Atrial fibrillation (AF) is a common dysrhythmia associated with significant morbidity
and mortality. Although many patients have stable AF, some patients can present with
a rapid ventricular response (RVR). In these patients, it is important to lower their
heart rate. However, there are several options available for rate control in the emergency
department setting.
Clinical Question
What is the most effective agent for rate control for the patient with AF in RVR?
Evidence Review
Studies retrieved included two prospective, randomized, double-blind studies and six
retrospective cohort studies. These studies provide estimates of the efficacy and
safety of calcium channel blockers and β-blockers for rate control in those with AF
with RVR.
Conclusion
Based upon the available literature, diltiazem likely achieves rate control faster
than metoprolol, though both agents seem safe and effective. Clinicians must consider
the individual patient, clinical situation, and comorbidities when selecting a medication
for rate control.
Keywords
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Article info
Publication history
Published online: July 29, 2022
Accepted:
July 10,
2022
Received in revised form:
June 10,
2022
Received:
March 6,
2022
Footnotes
This review does not reflect the views or opinions of the U.S. government, Department of Defense, U.S. Army, U.S. Air Force, or SAUSHEC EM Residency Program.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
