Is beta-blockade useful in heart failure patients with atrial fibrillation? An analysis of data from two previously completed prospective trials

Background Beta‐adrenergic blockade is of proven value in chronic heart failure. It is uncertain, however, if beta‐blockade provides a similar degree of clinical benefit for heart failure patients with atrial fibrillation (AF) as those in sinus rhythm (SR). Aims To compare the effectiveness of beta...

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Bibliographic Details
Published in:European journal of heart failure 2002-08, Vol.4 (4), p.489-494
Main Authors: Fung, Jeffrey W.H., Chan, Skiva K.W., Yeung, Leata Y.C., Sanderson, John E.
Format: Article
Language:English
Subjects:
Adrenergic beta-Antagonists - adverse effects
Adrenergic beta-Antagonists - therapeutic use
Adult
Aged
Aged, 80 and over
atrial fibrillation
Atrial Fibrillation - drug therapy
Atrial Fibrillation - physiopathology
beta-blockers
Carbazoles - adverse effects
Carbazoles - therapeutic use
Carvedilol
Chronic Disease
Comorbidity
Double-Blind Method
Female
heart failure
Heart Failure - drug therapy
Heart Failure - physiopathology
Humans
Male
Metoprolol - adverse effects
Metoprolol - therapeutic use
Middle Aged
Propanolamines - adverse effects
Propanolamines - therapeutic use
Prospective Studies
Stroke Volume - drug effects
Treatment Outcome
Ventricular Function, Left - drug effects
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Summary:Background Beta‐adrenergic blockade is of proven value in chronic heart failure. It is uncertain, however, if beta‐blockade provides a similar degree of clinical benefit for heart failure patients with atrial fibrillation (AF) as those in sinus rhythm (SR). Aims To compare the effectiveness of beta blockade in patients with heart failure and AF. Methods Patients with chronic heart failure were randomized to treatment (double blind) with metoprolol 50 mg twice daily or carvedilol 25 mg twice daily in addition to standard therapy. Response was assessed after 12 weeks by a quality of life questionnaire, New York Heart Association class, exercise capacity (6‐min walk test), radionucleotide ventriculography for LVEF, 2‐D echocardiography measurement of left ventricular (LV) dimensions and diastolic filling and 24‐h electrocardiograph monitoring to assess heart rate changes. Results Both beta‐blockers produced significant improvements in LVEF in both the SR group: (+6±10% at 12‐week, P
ISSN:1388-9842
1879-0844
DOI:10.1016/S1388-9842(02)00031-4