From a safety perspective, there was no difference between the groups with respect to hypotension (systolic blood pressure < 90 mm Hg) and bradycardia (HR < 60 bpm).ĭiltiazem was more effective in achieving rate control in ED patients with AFF and did so with no increased incidence of adverse effects.Ītrial fibrillation atrial flutter diltiazem metoprolol rate control.Ĭopyright © 2015 Elsevier Inc. Mean decrease in HR for the diltiazem group was more rapid and substantial than that of the metoprolol group. By 30 min, 95.8% of the diltiazem group and 46.4% of the metoprolol group reached the target HR < 100 bpm (p < 0.0001). In the first 5 min, 50.0% of the diltiazem group and 10.7% of the metoprolol group reached the target heart rate (HR) of <100 beats per minute (bpm) (p < 0.005). The study team monitored each subject's systolic and diastolic blood pressures and heart rates for 30 min. The abnormal firing of electrical impulses causes the atria (the top chambers in the heart) to quiver (or fibrillate). Our aim was to compare the effectiveness of diltiazem with metoprolol for rate control of AFF in the ED.Ī convenience sample of adult patients presenting with rapid atrial fibrillation or flutter was randomly assigned to receive either diltiazem or metoprolol. The most common symptom: a quivering or fluttering heartbeat Atrial fibrillation, also called AFib or AF, is the most common type of irregular heartbeat.
#Difference between a flutter and afib trial
To date, only one small prospective, randomized trial has compared the effectiveness of diltiazem and metoprolol for rate control of AFF in the ED and concluded no difference in effectiveness between the two agents. However, there is considerable regional variability in emergency physician practice patterns and debate among physicians as to which agent is more effective. Diltiazem (calcium channel blocker) and metoprolol (beta-blocker) are both commonly used to treat atrial fibrillation/flutter (AFF) in the emergency department (ED).
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