Safety of Intravenous Diltiazem in Reduced Ejection Fraction Heart Failure with Rapid Atrial Fibrillation

Background and Objective Diltiazem is a nondihydropyridine calcium channel blocker that is used to control rapid ventricular response in patients who have atrial fibrillation or flutter. Diltiazem has a negative inotropic effect and may cause hemodynamic decompensation in patients with reduced ejection fraction. This study evaluated outcomes in patients who had low ejection fraction and were treated with diltiazem. Methods This was a retrospective chart review in 635 patients who were hospitalized because of rapid atrial fibrillation and who were treated with intravenous diltiazem. Outcomes were evaluated for patients in two groups based on ejection fraction (EF): normal (EF ≥ 50%) and low EF (EF