The role of beta-adrenergic blocking agents in preventing sudden cardiac death.
The failure of encainide and flecainide to reduce mortality after infarction in the Cardiac Arrhythmia Suppression Trial and the failure of low-dose amiodarone to prevent sudden cardiac death in patients with a low left ventricular ejection fraction has shifted attention to other strategies, such as beta-adrenergic blocking agents, to prevent sudden cardiac death. Evidence suggesting that beta-adrenergic blocking agents might be useful, especially in patients with low left ventricular ejection fraction, is accumulating. Previous data from studies using beta-adrenergic blocking agents and the mechanisms by which beta-adrenergic blocking agents might be of value in preventing sudden cardiac death are reviewed. These considerations and the availability of new investigational beta-adrenergic blocking agents with vasodilator properties provide a new opportunity to test the hypothesis that beta-adrenergic blocking agents are useful in preventing sudden cardiac death, especially in patients with a low left ventricular ejection fraction.
Pitt
B
B
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0366.
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000517:prevention & control; D002303:Cardiac Output, Low / Q000150:complications; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000188:drug therapy; D002395:Catecholamines / Q000037:antagonists & inhibitors; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D004232:Diuretics / Q000009:adverse effects; D004656:Enalapril / Q000627:therapeutic use; D006352:Heart Ventricles; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000150:complications
D000319:Adrenergic beta-Antagonists; D002395:Catecholamines; D004232:Diuretics; D004656:Enalapril; D008274:Magnesium