Kings College London, UK
Title: Are beta blockers more effective than calcium channel blockers in controlling heart rate in patients with atrial fibrillation?
Mohammad Murtaza Zaman was born on the 10th of April 1985 in a small town called Wah in the Rawalpindi district of Pakistan. After completing his schooling in Wah he went to Army Medical College Rawalpindi for his MBBS.He completed his degree in 2009 and went to the United Kingdom for further training. Subsequently he went through the UK foundation training,core medical training and passed his MRCP exams. Currently he is doing his masters degree in Cardiology from Kings College London as well as a fellowship in cardiology at Lister Hospital. His goal is to train as an interventional cardiologist and go back to Pakistan.
Atrial fibrillation is the most common sustained cardiac arrhythmia and results in significant mortality and morbidity predominantly due to ischemic stroke and heart failure. The prevalence is rising due to an increasing elderly population. Improved management strategies for ischemic heart disease and heart failure has resulted in a longer life expectancy and therefore increases the likelihood of developing AF secondary to these cardiac conditions. The American College of Cardiology, European College Society of Cardiology and NICE recommend a beta-blocker or a rate limiting calcium-channel blocker as first line treatment for controlling heart rate in patients who are haemodynamically stable. In clinical practice there seems to be debate among clinicians as to the superiority of one agent over the other. Searches were conducted in November 2015 on Embase (1974 to 2015 November), Ovid Medline (1946 to November Week 2, 2015) and the Cochrane Database. Four main facets were searched; ‘atrial fibrillation’, ‘beta-blockers’, ‘calcium-channel blockers’ and ‘rate control’. In total one hundred and nine (n=109) papers were returned. The duplicates were removed leaving ninety three (n=93) papers. All titles were reviewed and seventy-four were removed as they were irrelevant with regards to the question. Nineteen (n= 19) abstracts were pursued out of which fourteen were discarded for not meeting the eligibility criteria. Statistical analysis was carried out using the Review Manager software. The results showed that calcium-channel blockers were more effective than beta-blockers in controlling the heart rate at 20 minutes with a trend towards significance.