Podcast 773: Atrial Fibrillation Medications

Atrial fibrillation is an irregular heart rhythm that sometimes requires rate control in setting of rapid ventricular response (RVR)

Calcium channel blocker and beta blockers are the most frequently used medications to block the AV node and slow down the heart rate in atrial fibrillation with RVR

If a patient is on one of these agents at home, the IV form should be used first

Recent systematic review and meta-analysis found 3 trials addressing which medication to use to control heart rate in atrial fibrillation with RVR with a total of 150 patients

Found diltiazem, a CCB, was 4x more likely to reduce heart rate than metoprolol

50% of patients had a normal heart rate at 21 minutes with diltiazem versus 22% in those who received metoprolol

Both agents had a similar decrease in blood pressure after administration