Diltiazem Versus Metoprolol for Rate Control in Patients Presenting to the Emergency Department in Atrial Fibrillation John Tyrrell, Derrick Clay, Miles Lane, Robert Steed Spartanburg Regional Medical Center - PGY1 - Spartanburg, SC
Background/Purpose: Nondihydropyridine calcium channel blockers (nCCBs) and beta-blockers (BBs) and are both first line options for rate control in patients with atrial fibrillation with rapid ventricular rate (AF RVR). Guidelines suggest both are equally efficacious.
A national shortage of intravenous diltiazem, a nCCB, forced utilization of alternative agents including metoprolol, a BB. This study was conducted to compare outcomes for patients in AF with RVR managed with nCCB versus BB.
Methodology: This is a single-center, retrospective cohort chart review looking at patient encounters between November 1, 2016 _x0013_ July 31, 2018, measuring the success rate of adult patients reaching target heart rate (HR) after administration of either a nCCB or BB in the ED for AF with RVR. Patients were excluded if they had unstable AF or if they received electrical cardioversion or chemical cardioversion with a Class I or III antiarrhythmic prior to administration of the study drugs.
Presentation Objective: Compare effectiveness of rate control agents for patients presenting to the ED in stable AF with RVR.
Self-Assessment: Are calcium channel blockers superior to beta blockers for rate control in stable AF with RVR?
