Diltiazem vs Metoprolol in AF+HFrEF

IT MAKES NO DIFFERENCE NOW- CALCIUM CHANNEL BLOCKER OR BETA BLOCKER FOR ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE & HEART FAILURE WITH REDUCED EJECTION FRACTION

SGEM#388 - By admin - January 07, 2023

CLINICAL QUESTION: IN PATIENTS WITH HFrEF PRESENTING TO THE ED IN AF WITH RVR, ARE THERE SIGNIFICANT DIFFERENCES IN ADVERSE OUTCOMES FOR PATIENTS TREATED WITH IV DILTIAZEM VS IV METOPROLOL?

KEY RESULT: NO STATISTICAL DIFFERENCE IN ADVERSE EFFECTS DUE TO THE INTERVENTIONS

• No statistical difference in any of the components of the composite outcome except for worsening CHF symptoms (33% vs. 15%, P = 0.019).
• Worsening CHF was driven by increased oxygen requirement within four hours

SGEM BOTTOM LINE: THERE IS INSUFFICIENT EVIDENCE TO SUGGEST A DIFFERENCE IN TOTAL ADVERSE OUTCOMES FOR PATIENTS PRESENTING TO THE ED IN ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE TREATED WITH IV DILTIAZEM VS METOPROLOL.