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Atrial fibrillation - Management
Which initial drug treatment should I offer for rate control of atrial fibrillation?
- Offer a beta-blocker or rate-limiting calcium-channel blocker (diltiazem or verapamil), unless this is contraindicated.
- The choice between beta-blocker and calcium-channel blocker will depend on the person's current medication and comorbidities.
- Diltiazem (off-licensed use for atrial fibrillation) is preferred to verapamil because verapamil has a greater negative inotropic effect on the heart and interacts with digoxin.
- For further information, see the prescribing sections on beta-blockers and calcium-channel blockers.
- If the person has a sedentary lifestyle, digoxin is an alternative option.
- Digoxin is only adequate for older, sedentary people in whom rate control is not needed during exercise.
- For further information, see the prescribing section on digoxin.
In depth
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