Rate control in atrial fibrillation is a usual battle in emergency departments. Oral medications have a natural superiority to intravenous ones because they are easy-to-use and decrease the workload in busy emergency departments.

This study wants to find an effective oral medication for rate control in rapid ventricular response atrial fibrillation. Propranolol and Metoprolol, Diltiazem and Verapamil are compared in patients with a stable hemodynamic status.

Inclusion Criteria:

• Age more than 18 years old
• Stability in hemodynamic

Exclusion Criteria:

• Systolic blood pressure less than 90 mm Hg
• Altered mental status attributable to rapid ventricular response atrial fibrillation
• Acute pulmonary edema attributable to rapid ventricular response atrial fibrillation
• Chest pain attributable to rapid ventricular response atrial fibrillation
• Allergy to Propranolol or Metoprolol or Verapamil or Diltiazem
• History of asthma