• J. Cardiovasc. Pharmacol. Ther. · Sep 2007

    Randomized Controlled Trial Comparative Study

    Conversion of atrial fibrillation to sinus rhythm during treatment with intravenous esmolol or diltiazem: a prospective, randomized comparison.

    • Sohail Hassan, Ahmad M Slim, Slim Ahmad, Desikan Kamalakannan, Rami Khoury, Edward Kakish, Viqar Maria, Sujood Ahmed, Luis A Pires, Steve L Kronick, Hakan Oral, and Fred Morady.
    • St John Hospital and Medical Center, Detroit, Michigan 48236, USA. soli786 @yahoo.com
    • J. Cardiovasc. Pharmacol. Ther. 2007 Sep 1;12(3):227-31.

    AbstractPrior 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.

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