Comparison of the effectiveness of intravenous diltiazem and metoprolol in controlling the rapid ventricular rate in patients with atrial fibrillation

Abstract

Objective To compare the effectiveness between dilfiazem and metoprolol administered intra-venously on controlling the ventricular tachy-cardia in patients with atrial fibrillation (AF). Method From Jan-uaxy 2003 to July 2006, 48 AF patients in the Second Hospital, Jilin University, with a ventricular rate > 120 beats per minute and systolic blood pressure > 100 mmHg were enrolled and divided into dihiazem group (10 mg, Ⅳ, n = 24) or metoprolol group (5 mg, Ⅳ, n = 24). Blood pressure and heart rote were re-checked at different inter-vals of 5, 10, 15 and 30 minutes,respectively. Successful treatment was defined as ventricular rate 20% of the pre-treatment level, or restoumtion of sinus rhythm. Results Compared with pre-treatment value, a significant deceleration in ventricular response to AF was observed after treatment in both groups at each interval (P < 0.01). However, the ventricular rate in the diltiazem group was significantly lower than that in the metoprolol group (P <0.05) at all intervals but 30 minutes. A slight decrease in blood pressure was ob-served in both groups. The drop of blood pressure between two groups was comparable. The successful treatment at the interval of 30 minutes was achieved in 91.7% of patients in dihiazem group and 83.3% of patients in metopro-lol group (P < 0.05). Conclusions Both diltiazem (10 mg, Ⅳ) and metoproiol (5 mg, Ⅳ) are effective on con-trolling the accelerated ventricular response to AF, in particular, the effect of diltiazem seems much superior to ahat of metoprolol. Key words: Atrial fibrillation; Diltiazem; Metoprolol ; Intravenous; Effectiveness