{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:19:02Z","timestamp":1789604342473,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,3,20]],"date-time":"2013-03-20T00:00:00Z","timestamp":1363737600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2013,3]]},"abstract":"Abstract<\/jats:title>Objectives<\/jats:title>Many patients with atrial fibrillation (AF<\/jats:styled-content>) are not candidates for rhythm control and may require rate control, typically with beta\u2010blocking (BB<\/jats:styled-content>) or calcium channel blocking (CCB<\/jats:styled-content>) agents. Although these patients appear to have a low 30\u2010day rate of stroke or death, it is unclear if one class of agent is safer or more effective. The objective was to determine whether BB<\/jats:styled-content>s or CCB<\/jats:styled-content>s would have a lower hospital admission rate and to measure 30\u2010day safety outcomes including stroke, death, and emergency department (ED) revisits.<\/jats:p><\/jats:sec>Methods<\/jats:title>This retrospective cohort study used a database from two urban EDs to identify consecutive patients with ED<\/jats:styled-content> discharge diagnoses of AF<\/jats:styled-content> from April 1, 2006, to March 31, 2010. Comorbidities, rhythms, management, and immediate outcomes were obtained by manual chart review, and patients with acute underlying medical conditions were excluded by predefined criteria. Patients managed only with rate control agents were eligible for review, and patients receiving BB<\/jats:styled-content> agents were compared to those receiving CCB<\/jats:styled-content> agents. The primary outcome was the proportion of patients requiring hospital admission; secondary outcomes included the ED<\/jats:styled-content> length of stay (LOS<\/jats:styled-content>), the proportion of patients having adverse events, the proportion of patients returning within 7 or 30\u00a0days, and the number of patients having a stroke or dying within 30\u00a0days.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 259 consecutive patients were enrolled, with 100 receiving CCB<\/jats:styled-content>s and 159 receiving BB<\/jats:styled-content>s. Baseline demographics and comorbidities were similar. Twenty\u2010seven percent of BB<\/jats:styled-content> patients were admitted, and 31.0% of CCB<\/jats:styled-content> patients were admitted (difference\u00a0=\u00a04.0%, 95% confidence interval [CI<\/jats:styled-content>]\u00a0=\u00a0\u22127.7% to 16.1%), and there were no significant differences in ED LOS<\/jats:styled-content>, adverse events, or 7\u2010 or 30\u2010day ED<\/jats:styled-content> revisits. One patient who received metoprolol had a stroke, and one patient who received diltiazem died within 30\u00a0days.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In this cohort of ED<\/jats:styled-content> patients with AF<\/jats:styled-content> and no acute underlying medical illness who underwent rate control only, patients receiving CCB<\/jats:styled-content>s had similar hospital admission rates to those receiving BB<\/jats:styled-content>s, while both classes of medications appeared equally safe at 30\u00a0days. Both CCB<\/jats:styled-content>s and BB<\/jats:styled-content>s are acceptable options for rate control.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12091","type":"journal-article","created":{"date-parts":[[2013,3,20]],"date-time":"2013-03-20T17:02:58Z","timestamp":1363798978000},"page":"222-230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Safety and Efficiency of Calcium Channel Blockers Versus Beta\u2010blockers for Rate Control in Patients With Atrial Fibrillation and No Acute Underlying Medical Illness"],"prefix":"10.1111","volume":"20","author":[{"given":"Frank Xavier","family":"Scheuermeyer","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine St. Paul's Hospital and the University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Grafstein","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Mount St Joseph's Hospital and the University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Stenstrom","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine St. Paul's Hospital and the University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Christenson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine St. Paul's Hospital and the University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Heslop","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine St. Paul's Hospital and the University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Heilbron","sequence":"additional","affiliation":[{"name":"Division of Cardiology St Paul's Hospital and the University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"McGrath","sequence":"additional","affiliation":[{"name":"Division of Cardiology St Paul's Hospital and the University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Innes","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine Foothills Hospital and the University of Calgary Calgary AB 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