Comparison of metoprolol and diltiazem according to echocardiographic findings of patients presenting to the Emergency Medicine Clinic with atrial fibrillation with rapid ventricular response

In this study, echocardiographic findings (left atrium A/P diameter, left ventricular cytolic/diastolic diameter, left ventricular hypertrophy and EF), vital parameters (fever, systolic/diastolic BP, pulse, and fingertip blood sugar) of patients with AF with rapid ventricular response were examined and the effectiveness of these agents and whether they were superior to each other were investigated.In our study, 120 patients who applied to Gaziantep University Emergency Medicine linic were examined prospectively and observationally. Diltiazem was given as the first treatment in 60 patients who were randomized and metoprolol was given as the first treatment in 60 patients.Of the patients who participated in the study, 53 (44.2%) were male and 67 (55.8%) were female. Additional retarding agent was needed in 21 patients (35%) given metoprolol and 11 patients (18.3%) given diltiazem.The need for additional retarding agent was found to be statistically significant in patients who started metoprolol (p<0.039). In patients with left ventricular hypertrophy, the need for additional retardation treatment was found to be statistically significant in the use of metoprolol (p<0.02). There was no significant difference between the efficacy of metoprolol and diltiazem treatment according to the patients' left atrial AP diameter, left ventricular systolic/diastolic diameter and EF measurements. In our study, unlike the literature, no statistically significant difference was found in terms of the need for additional retarding agents in patients with heart valve disease who were started with diltiazem and metoprolol (p<0.158). In our study, unlike the literature, echocardiography examinations were performed by emergency medicine physicians who received Basic USG training within the scope of Bedside Focused Ultrasonography core training. In our study, diltiazem was found to be superior to metoprolol in first dose effectiveness.