title: Conversion of atrial fibrillation to sinus rhythm during treatment with intravenous esmolol or diltiazem: a prospective, randomized comparison.
abstract: 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.
authors: St John Hospital and Medical Center, Detroit, Michigan 48236, USA. soli786 @yahoo.com
authors: Sohail
authors: S
authors: Hassan
authors: Ahmad M
authors: AM
authors: Slim
authors: Slim
authors: S
authors: Ahmad
authors: Desikan
authors: D
authors: Kamalakannan
authors: Rami
authors: R
authors: Khoury
authors: Edward
authors: E
authors: Kakish
authors: Viqar
authors: V
authors: Maria
authors: Sujood
authors: S
authors: Ahmed
authors: Luis A
authors: LA
authors: Pires
authors: Steve L
authors: SL
authors: Kronick
authors: Hakan
authors: H
authors: Oral
authors: Fred
authors: F
authors: Morady
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000188:drug therapy*; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D004110:Diltiazem / Q000009:adverse effects / Q000627:therapeutic use*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D011412:Propanolamines; D004110:Diltiazem; C036604:esmolol