ObjectiveTo investigate the efficacy and safety of intravenous diltiazem in controlling ventricular rate in elderly patients with atrial fibrillation. MethodWe retrospectively analyzed the clinical data of patients suffering from atrial fibrillation with rapid ventricular rate presented to the Emergency Department between January 2014 and January 2015, and found that 57 elderly patients aged over 70 were treated with intravenous diltiazem for ventricular rate controlling. We analyzed the general situation of this group of patients, the changes of heart rate and mean arterial pressure before and after the treatment, and the adverse reactions to the treatment. ResultsThe total effective rate was 92.9%, and the mean onset time was (13.3±7.3) minutes. The mean arterial pressure showed no significant difference after treatment, and the heart function showed no significant deterioration. Only 4 patients (7.0%) had symptoms of transient hypotension. ConclusionsFor elderly patients with atrial fibrillation with rapid ventricular rate, intravenous diltiazem can control the ventricular rate rapidly, efficiently, safely, and sustainably.