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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