Key result
Beta-blockers for AF rate control are linked to ~22% lower hospital admission rates vs CCBs.
Why the study?
Previous studies of emergency department rate control in atrial fibrillation patients have been limited by relatively small sample sizes, necessitating examination of beta-blocker versus calcium channel blocker use and associated hospitalization rates.
Does the use of beta-blockers compared to calcium channel blockers reduce hospital admission in emergency department patients with atrial fibrillation?
Population
1,639 AF patients visiting 24 hospital EDs in Ontario, Canada
Comparison
Beta-blockers versus nondihydropyridine calcium channel blockers for rate control
Design
Preplanned substudy with hierarchical logistic regression modeling across multiple EDs
Follow-up
2 hours for heart rate assessment
Authors
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May support beta-blocker preference for ED AF rate control; leaves open need for RCTs before practice change.
Observational (n=1,639)
Yes
Does the use of beta-blockers compared to calcium channel blockers reduce hospital admission in emergency department patients with atrial fibrillation?
Absolute Risk Reduction: 11.6 (95% CI 7.9–16.2)
Absolute Event Rate: 40% vs 51.6%
Absolute Risk Reduction: 11.6%
In emergency department patients with atrial fibrillation, rate control with beta-blockers was associated with a lower rate of hospital admission compared to calcium channel blockers.
Atzema et al. (2017) conducted an observational in Atrial fibrillation (n=1,639). Beta-blockers vs. Calcium channel blockers was evaluated on Hospital admission (difference 11.6%, 95% CI 7.9-16.2). Beta-blockers for rate control in atrial fibrillation were associated with lower hospital admission rates than calcium channel blockers (40.0% vs 51.6%; difference 11.6%, 95% CI 7.9-16.2%).
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