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Atrial fibrillation - Management
Which beta-blocker should I use?
- Atenolol, acebutolol, metoprolol, nadolol, oxprenolol, and propranolol are licensed to treat atrial fibrillation.
- The choice of beta-blocker will usually depend on the person's comorbidities, local recommendations, and cost.
- For people with atrial fibrillation alone, atenolol may be preferred because it may be taken once a day and is less expensive than other beta-blockers.
- For people with hypertension and angina, atenolol or metoprolol may be preferred. For more information, see the CKS topic on Angina.
- For people who have atrial fibrillation and have had a previous myocardial infarction (without heart failure), metoprolol (standard release), propranolol (standard release), or atenolol may be preferred. For more information, see the CKS topic on MI - secondary prevention.
- For people with atrial fibrillation and heart failure, bisoprolol, carvedilol, and nebivolol may be preferred. For more information, see the CKS topic on Heart failure - chronic.
Basis for recommendation
- The National Institute for Health and Clinical Excellence (NICE) does not specify which beta-blocker should be used to treat atrial fibrillation. This recommendation is based on practical advice. The choice of beta-blocker will ultimately depend on the person's comorbidities, local recommendations, and cost.
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