THE EFFECTIVENESS OF BETA-BLOCKERS VERSUS CALCIUM CHANNEL BLOCKERS IN RATE CONTROL OF ATRIAL FIBRILLATION IN AN EMERGENCY DEPARTMENT: A SYSTEMATIC REVIEW

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It is related to increased stroke, heart failure, and hospital admission. Therefore, this systematic review was conducted to compare the effectiveness of calcium channel blockers (CCB) with beta-blockers (BB) for acute rate control of AF in the emergency department. Methods: We systematically retrieved articles written in English until December 2018 G.C. from the following databases: Embase, PubMed/Medline, Web of Science, and Google Scholar. A preferred reporting item for systematic reviews and meta-analysis (PRISMA) protocol was used. Result: Out of eight hundred two studies, three studies met our inclusion criteria with sufficient data. These studies were randomized double-blinded (n=152), comparing CCB with BB. The systemic review revealed that diltiazem was highly effective in reducing ventricular rate compared to metoprolol at each time interval (SMD=-0.78; 95%CI: -1.21 to -0.35). Adverse events were rare and similar, but calcium channel blockers reduced arrhythmia-related symptoms. Conclusion: There were insufficient data and a paucity of controlled clinical trial data. A well-designed and high-quality randomized study is needed.