Journal of Cardiovascular Pharmacology and Therapeutics

 

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Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 12, No. 3, 227-231 (2007)
DOI: 10.1177/1074248407303792

Conversion of Atrial Fibrillation to Sinus Rhythm During Treatment With Intravenous Esmolol or Diltiazem: A Prospective, Randomized Comparison

Sohail Hassan, MBBS, FACC

St John Hospital and Medical Center, Detroit, soli786 @yahoo.com

Slim Ahmad, MD

St John Hospital and Medical Center, Detroit

Desikan Kamalakannan, MD, MRCP

St John Hospital and Medical Center, Detroit

Rami Khoury, MD

St John Hospital and Medical Center, Detroit

Edward Kakish, DO

St John Hospital and Medical Center, Detroit

Viqar Maria, MBBS

St John Hospital and Medical Center, Detroit

Sujood Ahmed, MD

St John Hospital and Medical Center, Detroit

Luis A. Pires, MD, FACC

St John Hospital and Medical Center, Detroit

Steve L. Kronick, MD, MS

University of Michigan Health System, Ann Arbor, Michigan

Hakan Oral, MD, FACC

University of Michigan Health System, Ann Arbor, Michigan

Fred Morady, MD, FACC

University of Michigan Health System, Ann Arbor, Michigan

Prior studies have suggested that intravenous diltiazem reduces the probability of spontaneous conversion of atrial fibrillation (AF) to sinus rhythm in the electrophysiology laboratory and in patients with postoperative AF. Whether diltiazem exerts the same effect in patients presenting to the emergency department (ED) with spontaneous AF is unclear. Fifty patients presenting to the ED with new-onset or paroxysmal AF and a rapid ventricular rate (>100 beats per minute) were randomly assigned to receive intravenous diltiazem or esmolol during the first 24 hours of presentation. Conversion to sinus rhythm occurred in 10 patients (42%) in the diltiazem group compared with 10 patients (39%) in the esmolol group (P = 1.0). Diltiazem does not decrease the likelihood of spontaneous conversion of AF to sinus rhythm in the ED setting.

Key Words: atrial fibrillation • diltiazem • esmolol


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