Effect of Oral and Intravenous Diltiazem Protocol for Emergency Department Atrial Fibrillation

Emergency Department Atrial Fibrillation Oral Diltiazem Observation Protocol

The primary objective of the study is to reduce hospital admission and decrease time to disposition through establishing an effective treatment protocol for AF and Atrial Flutter in the Emergency Department of Spectrum Health Lakeland. Secondary outcome is to measure if oral diltiazem is an effective HR controlling agent in AF RVR and Flutter.

Inclusion Criteria:

• Heart rate >125
• Systolic BP>110
• Atrial Fibrillation/Flutter confirmed on ECG.
• Meets observation unit requirements (performs certain ADL's (acts of daily living)
• Age>18.

Exclusion Criteria:

• Wolf-Parkinson-White syndrome
• ST Elevation Myocardial Infarction
• Pregnant
• Clinical diagnosis of Sepsis,
• Decompensated HF
• allergy to Diltiazem
• provider discretion
• clinical need for cardioversion