Beta Blockers Improve Outcome in Patients with Heart Failure and Atrial Fibrillation: U.S. Carvedilol Study

Cardiac Electrophysiology Review - Tập 7 - Trang 229-232 - 2003
Karthik Ramaswamy1
1University of Massachusetts Medical School, Worcester, USA

Tóm tắt

Atrial fibrillation (AF) is present in a significant number of patients with heart failure (HF) caused by left ventricular systolic dysfunction and is associated with increased morbidity and mortality. The deleterious interaction of AF and HF is mediated through a number of mechanisms including hemodynamic alterations and activation of the sympathetic nervous system. Beta-blockers have been shown to improve symptoms and survival in patients with HF. In addition, beta-blockers have been used in patients with AF, primarily for rate control. A retrospective analysis of the U.S. Carvedilol Heart Failure Trial demonstrated that carvedilol improves outcomes in the high-risk subgroup of patients with HF and concomitant AF.

Tài liệu tham khảo

Fuster V, Ryden LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, Halperin JL, Kay GN, Klein WW, Levy S, McNamara RL, Prystowsky EN, Wann LS, Wyse DG. ACC/AHA/ESC Guidelines for the management of patients with atrial fibrillation. JAmColl Cardiol 2001;38(4):1231-1266. Joglar JA, Acusta AP, Shusterman NH, Ramaswamy K, Kowal RC, Barbera SJ, Hamdan MH, Page RL. Effect of carvedilol on survival and hemodynamics in patients with atrial fibrillation and left ventricular systolic dysfunction: Retrospective analysis of the US Carvedilol Heart Failure Trials Program. Am Heart J 2001;142:498-501. Dries DL, Exner DV, Gersh BJ, Domanski MJ, Waclawiw MA, Stevenson LW. Atrial fibrillation is associated with an increase risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: A retrospective analysis of the the SOLVD trials. J AmColl Cardiol 1998: 32:695-703. Wang TJ, Larson MG, Levy D, Vasan RS, Leip EP, Wolf PA, D'Agostino RB, Murabito JM, Kannel WB, Benjamin EJ. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality. The Framingham Heart Study. Circulation 2003;107:2920-2925. Middlekauff HR, Stevenson WG, Stevenson LW. Prognostic significance of atrial fibrillation in advanced heart failure. Circulation 1991;84:40-48. Shinbane JS, Wood MA, Jensen DN, Ellenbogen KA, Fitzpatrick KA, Scheinman MM. Tachycardia-induced cardiomyopathy: A review of animal models and clinical studies. J AmColl Cardiol 1997;29:709-715. Naito M, David D, Michelson EL, Schaffenberg M, Dreifus LS. The hemodynamic consequences of cardiac arrhythmias: Evaluation of the relative roles of abnormal atrioventricular sequencing, irregularity of ventricular rhythm and atrial fibrillation in a canine model. Am Heart J 1983;106:284-291. Wasmund SL, LI JM, Page RL, Joglar JA, Kowal RC, Smith ML, Hamdan MH. Effect of atrial fibrillation and an irregular ventricular response on sympathetic nerve activity in human subjects. Circulation 2003;107(15):2011-2015. Eichhorn EJ, Heesch CM, Barnett JH, Alvarez LG, Fass SM, Grayburn PA, Hatfield BA, Marcoux LG, Malloy CR. Effect of metoprolol on myocardial function and energetics in patients with nonischemic dilated cardiomyopathy: A randomized, double-blind, placebo controlled study. J Am Coll Cardiol 1994;24(5):1310-1320. Packer MP, Bristow MR, Cohn JN, Colucci WS, Fowler MB, Gilbert EM, Shusterman NH. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 1996;334:1349-1355. CIBIS II Investigators and Committees. The cardiac insufficiency bisoprolol study II (CIBIS II): A randomized trial. Lancet 1999;353:9-13. MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL randomized intervention trial in congestive heart failure trial (MERIT-HF). Lancet 1999;353:2000-2007. Lechat P, Hulot J-S, Escolano S, Mallet A, Leizorovicz A, Werhlen-Grandjean M, Pochmalicki G, Dargie H. Heart rate and cardiac rhythm relationships with bisoprolol benefit in chronic heart failure in CIBIS II trial. Circulation 2001;103:1428-1433. Fung JW, Chan SK, Yeung LY, Sanderson JE. Is betablockade useful in heart failure patients with atrial fibrillation? An analysis of data from two previously completed prospective trials. Eur J Heart Fail 2002;4(4):489-494. Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, Kellen JC, Greene HL, Mickel MC, Dalquist JE, Corley SD, for the AFFIRM Investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med 2002;347:1825-1833. Gronefeld GC, Hohnloser SH. Beta-blocker therapy in atrial fibrillation. PACE 2003;26(Pt. II):1607-1612. Kuhlkamp V, Schirdewan A, Stagl K, Hornber M, Matthias P, Beck OA. Use of metoprolol CR/XL to maintain sinus rhythm after conversion from persistent atrial fibrillation: A randomized, double-blind, placebo-controlled study. J Am Coll Cardiol 2000;36:139-146. Page RL. Beta-blockers for atrial fibrillation: Must we consider asymptomatic arrhythmias? J Am Coll Cardiol 2000;36:147-150. S. Chen SA, Hsieh MM, Tai CT, Tsai CF, Prakash VS, Yu WC, Hsu TL, Ding YA, Chang MS. Initiation of atrial fibrillation by ectopic beats originating from the pulmonary veins: Electrophysiological characteristics, pharmacological responses, and effects of radiofrequency ablation. Circulation 1999;100:1879-1886.