Questioning Beta-Blockers in Patients with Heart Failure and AF

These medications may do no harm, but neither do they seem to improve mortality and hospitalization rates.

Atrial fibrillation (AF) and chronic systolic heart failure commonly coexist. Because beta-blockers are considered foundational evidence-based therapy for left ventricular systolic dysfunction (LVSD), many clinicians have presumably assumed that beta-blockers should be used as first-line agents to achieve rate control and reduce mortality in patients with both LVSD and AF. These researchers compared the relationship between beta-blocker therapy and outcomes in patients with heart failure and with or without AF in a manufacturer-sponsored meta-analysis (NCT00832442) that used patient-level data from 10 randomized, controlled trials of beta-blockers in 18,254 heart-failure patients.

Overall, 3066 patients (17%) had AF; they were older by 5 yea…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)