Abstract: Objective   To observe the clinical efficacy and safety of intravenous injection of Esmolol in the treatment of chronic obstructive pulmonary disease(COPD) with rapid atrial fibrillation. Methods   A total of 25 COPD patients with rapid atrial fibrillation were treated with intravenous injection of esmolol and sequentially with oral betaloc， and 33 cases of the control group were given intravenous injection of amiodarone and sequential oral amiodarone. The therapy effects on arrhythmia， blood pressure， heart rate and arterial blood gas were observed between two groups.Results  After the intervention group and control group were intravenously injected with esmolol and amiodarone respectively， the arrhythmia was significantly reduced with the difference of 92% vs 93.9% in the effective rate. Both groups resulted in decreased blood pressure but there were no need to use vasoactive drugs to maintain. For the safety， there were no severe adverse events in the intervention group. In the control group， two patients with amiodarone experienced severe bradycardia (<50 beats/min). There were no notable exacerbations in respiratory failure between two groups.Conclusion  Esmolol is safe and effective in the treatment of COPD with rapid atrial fibrillation， which can effectively control the ventricular rate and will not lead to respiratory failure exacerbations.

Key words: pulmonary disease, chronic obstructive； arrhythmias, cardiac； atrial fibrillation；adrenergic betaantagonists