Comparison of mortality rates among rate-control agents in patients with atrial fibrillation: a systematic review and meta-analysis

Abstract

Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide and is associated with increased mortality and morbidity. 1 A rate-control strategy is an effective treatment strategy for patients with AF as rapid ventricular response can contribute to left ventricular dysfunction and increased mortality. 2 However, data supporting the selection of rate-control medications are still lacking. We conducted a systematic review and metaanalysis to evaluate and compare mortality rates among beta-blocker (BB), calcium channel blocker (CCB), and digoxin for patients with AF undergoing rate-control strategy.

Use of Diltiazem in Chronic Rate Control for Atrial Fibrillation: A Prospective Case-Control Study

“…The current ESC guidelines [2], despite recognising the limitations of the available literature, still support BB as the first choice for rate controls in AF patients, especially in subjects with HF. However, the benefits of BB on all-cause mortality in patients with AF and HF have been questioned by a recent metanalysis and re-evaluation of the literature [33][34][35][36]. Our findings support the changes proposed by these guidelines compared to previous recommendations, such as the possibility of associating BB and NDCC, and advocate for new studies on more extended use of NDCC for rate control in AF.…”