This study evaluated the mean heart rate (by holter monitoring) of 60 patients with permanent Afib with 4 different medications: Diltiazem 360 mg/day, verapamil 240 mg/day, metoprolol 100 mg/day, or carvedilol 25 mg/day; each was given for 3 weeks in random order. The mean heart rate was 96 before treatment, 84 with carvedilol, 82 with metoprolol, 81 with verapamil, and 75 with diltiazem. Diltiazem also significantly reduced the severity and frequency of symptoms and should be the drug of choice for Afib rate control unless contraindicated (abstract).
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