Use of Diltiazem in Chronic Rate Control for Atrial Fibrillation: A Prospective Case-Control Study
Igor Diemberger,
Alberto Spadotto,
Giulia Massaro,
Martina Amadori,
Liviu Damaschin,
Cristian Martignani,
Matteo Ziacchi,
Mauro Biffi,
Nazzareno Galiè,
Giuseppe Boriani
Affiliations
Igor Diemberger
Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy
Alberto Spadotto
Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy
Giulia Massaro
Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy
Martina Amadori
Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy
Liviu Damaschin
Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy
Cristian Martignani
IRCCS Policlinico S.Orsola-Malpighi, U.O.C. di Cardiologia, 40138 Bologna, Italy
Matteo Ziacchi
IRCCS Policlinico S.Orsola-Malpighi, U.O.C. di Cardiologia, 40138 Bologna, Italy
Mauro Biffi
IRCCS Policlinico S.Orsola-Malpighi, U.O.C. di Cardiologia, 40138 Bologna, Italy
Nazzareno Galiè
Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum—University of Bologna, 40138 Bologna, Italy
Giuseppe Boriani
Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41125 Modena, Italy
Atrial fibrillation (AF) is a multifaceted disease requiring personalised treatment. The aim of our study was to explore the prognostic impact of a patient-specific therapy (PT) for rate control, including the use of non-dihydropyridine calcium channel blockers (NDDC) in patients with heart failure (HF) or in combination with beta-blockers (BB), compared to standard rate control therapy (ST), as defined by previous ESC guidelines. This is a single-centre prospective observational registry on AF patients who were followed by our University Hospital. We included 1112 patients on an exclusive rate control treatment. The PT group consisted of 125 (11.2%) patients, 93/125 (74.4%) of whom were prescribed BB + NDCC (±digoxin), while 85/125 (68.0%) were HF patients who were prescribed NDCC, which was diltiazem in all cases. The patients treated with a PT showed no difference in one-year overall survival compared to those with an ST. Notably, the patients with HF in ST had a worse prognosis (p p = 0.039). Our results suggest a potential outcome benefit of NDCC for rate control in AF patients, either alone or in combination with BB and in selected patients with HF.