Rate control Managemet of AFRVR in the ED 🇨🇦

✳️665 ED visits
✳️AF status: Permanent (53.4%)
✳️518 (77.9%) had RVR due to medical cause
✳️Received Rate-Control meds: Primary AFRVR (79.6%), Secodary AFRVR (32.6%)
✳️Metoprolol (71.4%) more effective than Diltiazem (12.9%)
✳️Total Adverse Events (⬇️BP, CHF, ⬇️HR, shock, ❤️ arrest): 9.1% in patients getting rate control; ⬇️ BP most common (7.3%)
✳️64% of primary AFRVR discharged home from ED
✳️59% of primary AFRVR with rate control achieved HR < 100 at discharge
✳️Authors concerned 1/3 of secondary AFRVR patients received rate-control in ED versus aggressively treating the underlying condition and not the rapid HR 🎯

✳️Conclusion: avoid rate control in secondary AFRVR and focus on underlying illness 🎯
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