CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Atrial fibrillation - Management
Who should not receive a rate-limiting calcium-channel blocker?
- People with the following conditions should not receive a rate-limiting calcium-channel blocker:
- Heart failure — they may precipitate heart failure.
- Cardiac outflow obstruction (significant aortic stenosis or obstructive hypertrophic cardiomyopathy) — vasodilatation may result in reduced cardiac output.
- High-degree atrioventricular block — verapamil and diltiazem may induce complete atrioventricular block.
- People taking beta-blockers should avoid verapamil and diltiazem. They can be co-prescribed but only on specialist advice.
Basis for recommendation
© NHS Institute for Innovation and Improvement