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Heart Failure Treatment May be Confounded by Arrhythmia

By jeremyc | February 26, 2013

A recent meta-study brought up questions about the effectiveness of beta blockers for treatment of heart failure in patients who have reduced LVEF (left ventricular ejection fraction) as well as atrial fibrillation. According to the study, treatment with beta blockers had no significant effect on reducing mortality in AF patients, which is in contrast with the positive effect it has on patients with sinus rhythm. The study was done by Dirk Van Veldhuisen and other colleagues from the University Medical Center Groningen, the Netherlands.

The meta-analysis was done on four randomized trials and involved four beta blockers as well as 8,680 patients diagnosed with heart failure, out of which 1,677 had atrial fibrillation. The researchers were quick to note that their meta-analysis did involve a subgroup that was not specified before and all four beta blockers were assumed to have similar effects.

Ryan Aleong and Michael Bristow of the University of Colorado, Aurora, U.S., who were editorialists for the study, agreed that the results of the study generate a hypothesis but more studies are needed before confirming it. They said, “In that regard, it would appear to be ethical to compare placebo to a β-blocker in AF-HFREF [HF with reduced LVEF] patients in that available data support equipoise.”

Through the meta-analysis, it was seen that the sinus rhythm patients had a 37 percent reduction in their mortality risk when they were administered a beta blocker as opposed to a placebo, and AF patients had a less significant 14 percent reduction.

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