Therefore, in patients with concomitant high blood pressure who may benefit from additional blood pressure lowering, calcium channel blockers may be a more ideal option for rate control. Beta blockers and Calcium channel blockers (CCBs) both dilate the blood vessels through different mechanisms, reducing pressure within and making it easier for the heart to pump blood.

Atrial fibrillation (AFib) is a type of arrhythmia, or abnormal heart rhythm.

Adequate ventricular rate control is usually a resting rate of less than 100 beats per minute, but lower resting rates may be appropriate. In the first 5 minutes, 50% in the diltiazem vs. 10.7% in the metoprolol group reached heart rate control (p < 0.005). Calcium channel blockers are more effective than digoxin when given orally for long-term rate control and should be the initial drug of choice. The addition of a nondihydropyridine calcium channel blocker should generally be avoided in patients who are already receiving a dihydropyridine calcium channel blocker (e.g., amlodipine, nifedipine), as only a minimal incremental impact on blood pressure is observed.Calcium channel blockers should be favored over beta blockers in patients with asthma (or other forms of pulmonary disease with a bronchospastic component) given the risk of exacerbating bronchospasm. Consequently, its use is associated with increased crude rates of mortality in observational analysis.Copyright® 2020 Radcliffe Medical Media. Take Home: Both calcium channel blockers and beta blockers were effective in controlling heart rate, but the medications and doses used were not reported. Where views/opinions are expressed, they are those of the author(s) and not of Radcliffe Medical Media.Radcliffe Cardiology is part of Radcliffe Medical Media, an independent publisher and the Radcliffe Group Ltd. The objective was to determine whether beta blockers or calcium channel blockers would have a lower hospital admission rate and to measure 30-day safety outcomes including stroke, death, and ED revisits. OBJECTIVES: Many patients with atrial fibrillation (AF) are not candidates for rhythm control and may require rate control, typically with beta-blocking (BB) or calcium channel blocking (CCB) agents. Calcium-channel blockers (CCBs) are a type of medicine often used to treat high blood pressure. Atrial fibrillation. Their use as initial therapy is especially advocated in black patients (although thiazides are a viable alternative), given improvements in long-term cardiovascular events compared to inhibitors of the renin-angiotensin-aldosterone system [8]. Digoxin may be useful in the presence of hypotension or an absolute contraindication to beta-blocker treatment.Atrial fibrillation (AF) and heart failure (HF) with or without systolic dysfunction are common cardiac conditions that frequently coexist and share multiple risk factors. The following are several common comorbidities of AF where one agent may be more ideal over another:Both beta blockers and non-dihydropyridine calcium channel blockers exert negative inotropic effects in the acute setting and should therefore be used with caution in patients with heart failure with reduced ejection fraction (HFrEF). Although clinicians are cautioned regarding their use in heart failure or hypotension, minimal guidance is provided on which of the two classes is most appropriate in an individual patient. HF is a risk factor for AF and AF is a risk factor for HF. Thus, the association between digoxin and/ or beta-blocker use and mortality may still be wrongly estimated. As a consequence, judicious selection of initial therapy may therefore avoid unnecessarily prolonging a patient’s hospitalization while therapy is transitioned. For these reasons, the use of non-dihydropyridine calcium channel blockers should generally be avoided in patients with HFrEF despite minimal differences in their acute risks [5].Although both classes are associated with improvements in major adverse cardiovascular events in patients with a history of myocardial infarction (MI), only beta blockers have been associated with reductions in the incidence of ventricular arrhythmias and sudden cardiac death [3, 4, 6]. Therefore, this may not be a fair comparison.

Medication changes during follow-up are not recorded in many observational studies. However, long-term beta blocker use confers significant improvements in survival whereas non-dihydropyridine calcium channel blockers either exert no beneficial effects or may even worsen outcomes [2-4]. When used to treat arrhythmias such as Atrial Fibrillation, verapamil prolongs the refractory period (the period of time immediately following electrical stimulation of the AV node) and slows the heart rate. It is not affiliated with or is an agent of, the Oxford Heart Centre, the John Radcliffe Hospital or the Oxford University Hospitals NHS Foundation Trust group.Atrial fibrillation, beta-blocker, digoxin, heart failureThe authors have no conflicts of interest to declare.Laurent Fauchier, Service de Cardiologie et Laboratoire d’Electrophysiologie Cardiaque, Centre Hospitalier Universitaire Trousseau, 37044 Tours, France. It is commonly prescribed for heart arrythmias, angina or chest pain and hypertension or high blood pressure. However, beta blockers need not be avoided in patients with chronic obstructive pulmonary disease (COPD) given lack of evidence to indicate harm and a potential benefit [9, 10].Clinicians may be cautioned against using beta blockers in a number of other disease states, including diabetes mellitus, peripheral vascular disease, depression, and erectile dysfunction. Verapamil can also lower blood pressure. 206 total patients (109 patients had rate control data documented).

In patients with atrial fibrillation (AF) and heart failure (HF) with or without systolic dysfunction, either rhythm control or rate control is an acceptable primary therapeutic option.