LAUSR

Beta-blockers and non-dihydropyridine calcium channel blockers (CCBs) are first-line therapy for heart rate (HR) control in atrial fibrillation (AF) and atrial flutter (AFL) . While diltiazem is used more frequently during inpatient practice than verapamil, a nationwide shortage of intravenous (IV) diltiazem starting in February 2018 led to the more frequent use of alternative agents for rate control, including IV verapamil. However, despite support from clinical practice guidelines, IV verapamil is prescribed much less frequently as a first strategy for rate control in AF/AFL. Lower utilization of verapamil compared with diltiazem naturally leads to an incomplete understanding about how the two CCBs compare in clinical practice. We performed a retrospective study to compare the efficacy and safety of these medications in controlling ventricular response inpatients with rapid AF and AFL in a single-center academic medical center.