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Esmolol and metoprolol are both beta-1 selective blockers used for heart rate control. Esmolol is an ultrashort-acting intravenous beta-blocker with a half-life of approximately 2 minutes, while metoprolol has a longer half-life of about 4 hours. The combination is used in clinical settings where oral metoprolol is given as pre-medication and intravenous esmolol is used as a "bailout" option when metoprolol alone doesn't achieve the desired heart rate reduction. This protocol has been shown to be safe and effective in controlling heart rate during procedures like coronary computed tomography angiography (CCTA).
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