What is a preferred rate control agent in acute atrial fibrillation with rapid ventricular response?

In the management of acute atrial fibrillation with rapid ventricular response, metoprolol is a preferred rate control agent due to its effectiveness in slowing the heart rate by acting on beta-adrenergic receptors. As a cardioselective beta-blocker, metoprolol primarily affects the heart, reducing myocardial oxygen demand and improving symptoms. It can be administered intravenously for rapid onset of action, making it particularly suitable for acute situations where immediate control of the ventricular rate is necessary.

Additionally, metoprolol has a well-established safety profile, and its use is supported by clinical guidelines for acute management of atrial fibrillation. It is commonly used in combination with other treatments, if necessary, to ensure effective rate control.

In contrast, digoxin typically works by increasing vagal tone and slowing conduction through the AV node, but it often takes longer to achieve an adequate response, making it less desirable for immediate rate control in acute settings. Amiodarone and sotalol, while they can be used for rate control, are more commonly recognized for their antiarrhythmic properties and are generally utilized for rhythm control rather than rapid ventricular rate management. Therefore, metoprolol stands out as the favored choice when immediate rate control