Observation of Effectiveness and safety of Intravenous Metoprolol on Atrial Fibrillation of Rapid Ventricular Rates with Heart Failure

OBJECTIVE To investigate the effectiveness and safety of intravenous metoprolol on the patients with atrial fibrillation of rapid ventricular rates complicated by heart failure.METHODS Patients with atrial fibrillation of rapid ventricular rates compli-cated by heart failure,who were treated by heart failure therapy regularly for half an hour,were divided into three groups,whose heart rate was above 100 beats/min and blood pressure was above 100/60 mmHg.The first group was administrated Metoprolol 10mg by minipump in an hour;the second group was administrated metoprolol 5 mg in 10 minutes by injection directly,adding other 5 mg if heart beats was still above 100 beats·min-1 and blood pressure was above 100/60 mmHg after 10 minutes;the third group was admi-nistrated normal saline as the control group.If either ventricular rate was down to 60 beats·min-1 or blood pressure was down to 90/60 mmHg,experiments would be terminated.Symptom,physical sign,heart rate,blood pressure,parameters of haemodynamics,blood BNP and ANP were observed at 0 hour and 1 hour after injection of metoprolol or normal saline.RESULTS The clinical symptom and physical sign were improved significantly in both intravenous metoprolol treated groups.Compared with control group,the heart rate and BNP of both intravenous metoprolol treated groups were decreased significantly(P0.05),the decrease of blood pressure in both intravenous metoprolol treated groups was not statistically significant compared with control group.In the parameters of haemodynamics,CI,CO,SV,SI,LVET were increased significantly in minipump group compared with the control group(P0.05),but the injection group did not have the similar effect.CONCLUSION Intravenous metoprolol is effective and safe for the management of rapid ventricular rates of atrial fibrillation with heart failure.