A review of carvedilol arrhythmia data in clinical trials.
beta-Blockers are currently being evaluated more intensively to define their role in clinical use as antiarrhythmic agents. beta-Adrenergic blockade has been studied in relation to atrial fibrillation, ventricular arrhythmias, and sudden death; however, it is apparent from a number of studies that not all beta-blockers are equally effective. Randomized clinical trial data, both in heart failure and post-myocardial infarction (MI) patients, have shown differences in mortality benefits in addition to a variable effect on arrhythmias and sudden death. Carvedilol, a third-generation beta-blocker with proven clinical benefit in the management of heart failure and post-MI patients, has properties that may make it an effective antiarrhythmic agent. This paper reviews the current clinical arrhythmia data available for carvedilol from large-scale clinical trials and small studies. The trial evidence demonstrates that carvedilol therapy can be an effective adjunctive rate-control therapy in patients with atrial fibrillation, prevent mortality in patients with heart failure or post-MI with left ventricular dysfunction, with or without atrial fibrillation, and reduce its onset and the incidence of ventricular arrhythmia and sudden death.
Kowey
Peter R
PR
Division of Cardiovascular Diseases, Main Line Health Heart Center, Wynnewood, PA, Philadelphia, PA 19096, USA. koweypr@mlhheart.org
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D017298:Bisoprolol / Q000627:therapeutic use; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004077:Digoxin / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008790:Metoprolol / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality; D011412:Propanolamines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D004077:Digoxin; D008790:Metoprolol; D000638:Amiodarone; D017298:Bisoprolol