Effects of diltiazem and esmolol on cycle length and spontaneous conversion of atrial fibrillation

Christian Sticherling, Hiroshi Tada, William Hsu, Anton C. Bares, Hakan Oral, Frank Pelosi, Bradley P. Knight, S. Adam Strickberger, Fred Morady*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: Calcium channel blocking agents have been shown to prolong the duration of atrial fibrillation. This study compared the effects of intravenous diltiazem and esmolol on the cycle length and conversion rate of pacing-duced atrial fibrillation. Methods and Results: In 41 adults without structural heart disease, atrial fibrillation was induced by rapid atrial pacing. After 3 minutes, either diltiazem (n = 13), esmolol (n = 15), or saline (n = 13) was infused. In the diltiazem group, the atrial fibrillation cycle length shortened by a mean of 43 milliseconds and became significantly shorter than in the control group, while the atrial fibrillation cycle length in the esmolol group did not change. Spontaneous termination of atrial fibrillation occurred significantly less often in the diltiazem group (23%) than in the esmolol (67%, P < 0.05) or placebo groups (77%, P = 0.01). Conclusions: Intravenous diltiazem shortens the atrial fibrillation cycle length and lowers the probability of spontaneous conversion of recent-onset atrial fibrillation to sinus rhythm. These results suggest that the use of diltiazem for acute rate control may unwittingly prolong the duration of recent-onset atrial fibrillation.

Original languageEnglish (US)
Pages (from-to)81-88
Number of pages8
JournalJournal of Cardiovascular Pharmacology and Therapeutics
Issue number2
StatePublished - 2002


  • Atrial fibrillation
  • Cardioversion
  • Diltiazem
  • Esmolol

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)
  • Pharmacology


Dive into the research topics of 'Effects of diltiazem and esmolol on cycle length and spontaneous conversion of atrial fibrillation'. Together they form a unique fingerprint.

Cite this