title: Clinical efficacy of beta1 selective adrenergic blockers in the treatment of neurocardiogenic syncope - a meta-analysis.
abstract: BACKGROUND
  Beta1 (B(1)) selective blockers have been widely used for the treatment of neurocardiogenic syncope though clinical trials have shown conflicting degrees of efficacy.
  
  
  OBJECTIVE
  To study the clinical efficacy of B(1) selective blockers compared to placebo in the treatment of neurocardiogenic syncope.
  
  
  METHODS
  Four placebo controlled randomized studies were identified after search of existing English language literature. Review Manager (RevMan version 5, Oxford, England) was used for statistical calculations. Both random and fixed effects models were used for analysis.
  
  
  RESULTS
  There was no demonstrable efficacy of B(1) blockers compared to placebo even after a pre-specified sensitivity analysis. There was a trend towards more adverse events in the beta blocker group compared to placebo (OR = 2.03 CI = 0.83-3.95, p = 0.12).
  
  
  CONCLUSIONS
  There is no clinical evidence for justifying the use of B(1) selective blockers in the treatment of adult neurocardiogenic syncope. These agents may in fact lead to a higher rate of adverse events compared to placebo.
authors.affiliation: Division of General Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL, USA. svallurupalli@siumed.edu
authors.forename: Srikanth
authors.initials: S
authors.lastname: Vallurupalli
authors.forename: Smita
authors.initials: S
authors.lastname: Das