Metoprolol Use In A-Fib with RVR

TO: EMS Personnel
FROM: Dr Todd Husty
DATE: July 22, 2026
RE: Metoprolol use in A-Fib with RVR

The Office of the Medical Director is implementing a new Metoprolol treatment parameter for patients with Atrial Fibrillation accompanied by Rapid Ventricular Response (RVR).

This update is straightforward and is not intended to complicate patient care. Please take the time to read the new parameter carefully and ensure you understand its indications and application.

This treatment approach has been recommended by our hospital emergency department partners as the preferred management strategy for appropriate unstable patients. It is important to emphasize that this protocol is not intended for patients who simply have an elevated heart rate. Clinical Judgement and adherence to the specified inclusion criteria remain essential.

Thank you for your attention to the update and for your continued commitment to providing safe, evidence-based patient care.

Respectfully,

Todd M. Husty, DO
Medical Director