Of those with AF, 73% of men and 75.6% of women develop HF.īoth the AF guidelines by the American Heart Association, American College of Cardiology, and Heart Rhythm Society and the HF guidelines by the American College of Cardiology Foundation and the American Heart Association recommend against the use of ND CCB in patients with HFrEF. Of patients with HF, 61.5% of men and 73% of women develop AF. Based on this relationship and the changes in myocardial structure, function, and conduction the two are also risk factors for one another. These two disease states share several common risk factors including, age, hypertension, diabetes mellitus, and heart disease. These disease states have a significant morbidity and mortality impact with AF leading to a 4 fold increase in stroke and 2 fold increase in death, while 50% of patients with a new HF diagnosis will die within 5 years. AF affects over 2 million people in the United States, while HF affects over 5 million. Condition or diseaseĪF and HF are frequently seen in the hospital setting. The purpose of this study is to assess the difference between metoprolol and diltiazem for the acute treatment of AF RVR in patients with HF with reduced ejection fraction (HFrEF). This recommendation is based on studies with long-term treatment. Non-dihydropyridine calcium channel blocker (diltiazem and verapamil) use is considered harmful and national guidelines recommend against use in patients with decompensated heart failure (HF). In the acute setting these patients are often treated with diltiazem, a non-dihydropyridine calcium channel blocker (ND CCB), or metoprolol, a beta blocker (BB).
There are also numerous reasons for patients to get AF with rapid ventricular rate (AF RVR) during hospitalization. Approximately 65% of those presenting to the ED with AF are admitted. Why Should I Register and Submit Results?Ītrial fibrillation (AF) is the most common arrhythmia, accounting for one third of all hospital admissions and 1% of all emergency department visits (ED).
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