AIMS: Atrial fibrillation (AF) is an important morbidity-mortality risk factor, especially in patients with heart failure (HF). Beta-blockers reduce morbidity and mortality in HF. The study was designed to estimate the preventive efficacy of beta-blocker treatment on AF occurrence in patients with HF. METHODS AND RESULTS: A systematic review of the literature was performed to identify all clinical trials evaluating beta-blockers' efficacy in HF. Eligible studies had to be randomized, placebo-controlled and providing information on the incidence of AF during follow-up among those with sinus rhythm at baseline. A total of seven studies which included 11 952 patients receiving a background treatment with angiotensin-converting enzyme-inhibitors could be found. Overall, beta-blockers significantly reduced incidence of onset of AF from 39 to 28 per 1000 patient-years: relative risk reduction=27% (95% confidence interval 14-38, P<0.001); heterogeneity test: P=0.096. A same trend of efficacy was observed in all trials except the SENIORS study. In this trial which included aged patients (>70 years) with systolic or diastolic HF, a higher prevalence of AF at baseline (35%) was observed compared with the mean baseline prevalence (13%). CONCLUSION: Beta-blockers appear to effectively prevent occurrence of AF in patients with systolic HF.
AIMS: Atrial fibrillation (AF) is an important morbidity-mortality risk factor, especially in patients with heart failure (HF). Beta-blockers reduce morbidity and mortality in HF. The study was designed to estimate the preventive efficacy of beta-blocker treatment on AF occurrence in patients with HF. METHODS AND RESULTS: A systematic review of the literature was performed to identify all clinical trials evaluating beta-blockers' efficacy in HF. Eligible studies had to be randomized, placebo-controlled and providing information on the incidence of AF during follow-up among those with sinus rhythm at baseline. A total of seven studies which included 11 952 patients receiving a background treatment with angiotensin-converting enzyme-inhibitors could be found. Overall, beta-blockers significantly reduced incidence of onset of AF from 39 to 28 per 1000 patient-years: relative risk reduction=27% (95% confidence interval 14-38, P<0.001); heterogeneity test: P=0.096. A same trend of efficacy was observed in all trials except the SENIORS study. In this trial which included aged patients (>70 years) with systolic or diastolic HF, a higher prevalence of AF at baseline (35%) was observed compared with the mean baseline prevalence (13%). CONCLUSION: Beta-blockers appear to effectively prevent occurrence of AF in patients with systolic HF.
Authors: Tyler W Barrett; Alan B Storrow; Cathy A Jenkins; Frank E Harrell; John Amdahl; Stephan Russ; Corey M Slovis; Dawood Darbar Journal: Am J Emerg Med Date: 2011-01-03 Impact factor: 2.469
Authors: Evan L Thacker; Paul N Jensen; Bruce M Psaty; Barbara McKnight; W T Longstreth; Sascha Dublin; Katherine M Newton; Nicholas L Smith; David S Siscovick; Susan R Heckbert Journal: Ann Pharmacother Date: 2015-01-27 Impact factor: 3.154
Authors: Emelia J Benjamin; Peng-Sheng Chen; Diane E Bild; Alice M Mascette; Christine M Albert; Alvaro Alonso; Hugh Calkins; Stuart J Connolly; Anne B Curtis; Dawood Darbar; Patrick T Ellinor; Alan S Go; Nora F Goldschlager; Susan R Heckbert; José Jalife; Charles R Kerr; Daniel Levy; Donald M Lloyd-Jones; Barry M Massie; Stanley Nattel; Jeffrey E Olgin; Douglas L Packer; Sunny S Po; Teresa S M Tsang; David R Van Wagoner; Albert L Waldo; D George Wyse Journal: Circulation Date: 2009-02-03 Impact factor: 29.690