Acute Atrial Fibrillation - Initial Options for Rate Control Diltiazem IV • Rapid onset and rapidly titratable • Easy to transition to oral • Generally considered most effective option for achieving immediate rate control Diltiazem (Oral) • Easy to directly transition to outpatient regimen Metoprolol (IV) • Easy to transition to oral metoprolol • Beneficial in HFrEF (long-term) Esmolol (IV) • Rapid onset and rapidly titratable • NO oral form, so transitioning to outpatient regimen is not as clear as with other options Amiodarone (IV) • Best acute option for patients with ADHF • Risks conversion to sinus rhythm • IV bolus can cause hypotension • Many toxicities with long-term oral use Digoxin (IV or PO) • Slowest onset of action • Rate control is most prominent when patient at rest • 3rd line agent • Does not cause hypotension - Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedi #Atrial #Fibrillation #Rate #Control #pharmacology #management #cardiology #AFib #Acute
