TAMING THE SRU
TAMING THE SRU - April 22, 2023 - By Bronwyn Finney
DISCUSSION
The researchers concluded that there was no difference in rate control at 30 minutes when utilizing diltiazem vs metoprolol based on this study. Other interesting notes included that those who received metoprolol were more likely to crossover to diltiazem after 30 minutes and additionally received more doses of medication overall. The study is unfortunately limited due to retrospective nature, probable selection bias due to small sample size and has limited generalizability due to exclusion of concurrent heart failure exacerbation on presentation. Additionally, average EF very high overall with predominantly HFpEF patients. Regarding diltiazem, it is worth noting that it has potential to be unsafe, as more hypotension developed overall, but very few patients required pressors. Additionally, many of the patients in the study ended up on diltiazem drips whether it be for ease of use, titratability or other factors. A wonderful next step would be to see a randomized control trial investigating this same clinical question…