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    Atrial fibrillation (AF) is a commonly encountered dysrhythmia in the Emergency Department (ED). Atrial flutter is less common but its management is very similar to that of AF. In patients with chronic AF or unknown time of onset and a rapid ventricular response (RVR), rate control and consideration and initiation of anticoagulation therapy are the standard ED approach. Both beta-blockers and calcium channel blockers are commonly used for rate control in the ED but it is unclear whether one of these agents is superior to the other as there is scant high-quality data on the topic (Demircan 2005). 38o C, acute STEMI, Known NYHA Class IV heart failure, chronic COPD, prehospital administration of any AV nodal blocking agent, history of allergic reaction to diltiazem or metoprolol, history of sick sinus or pre-excitation syndrome, history of anemia, pregnancy, breastfeeding or cocaine/methamphetamine use within 24 hours. Diltiazem is non-inferior to metoprolol for rapid rate control in patients with AF and RVR. This study helps to defend what is the most common practice in the ED for patients with AF and RVR who require rate control. The best available evidence demonstrates that diltiazem achieves rate control faster than metoprolol in patients with AF and RVR. Rate Control for Atrial Fibrillation What Is the Best Drug to Use? sertraline is it a narcotic Diltiazem vs. Metoprolol for Rate Control in Atrial Fibrillation - Core EM Compare Diltiazem vs Lopressor -
     
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