title: Heart rate-reducing effects of bisoprolol in Japanese patients with chronic atrial fibrillation: results of the MAIN-AF study.
abstract: BACKGROUND
  A variety of β-blockers are used to control heart rate (HR) in atrial fibrillation (AF); however, there have been few quantitative assessments of HR and blood pressure reductions with β-blocker monotherapy.
  
  
  RESULTS
  Seventy-eight patients with chronic (persistent or permanent) AF were administered bisoprolol (2.5mg/day) for 2 weeks. Subsequently, 48 patients judged to require a dose increase were either continued on 2.5mg/day (24 patients) or administered a higher dose (5mg/day; 24 patients) in a double-blind fashion for two further weeks. Change in mean HR as determined by Holter electrocardiogram was the primary endpoint. After 2 weeks of bisoprolol 2.5mg/day, mean HR was significantly lower than that before treatment (12.2±9.1beats/min, p<0.001). Mean HRs in the 5-mg and 2.5-mg continuation groups were also significantly decreased compared with those before treatment (17.3±12.9 and 11.4±7.4beats/min, respectively, both p<0.001), with a significant between-group difference (p=0.033). The HR reduction was greater during the day than at night. Although a greater reduction in systolic blood pressure was seen in the 5-mg group than in the 2.5-mg continuation group, the difference between groups was not significant. There were no serious adverse events.
  
  
  CONCLUSIONS
  This is the first quantitative analysis of β-blocker monotherapy in AF patients. Bisoprolol exhibits a dose-responsive HR reduction when administered at sequential doses of 2.5mg/day and 5mg/day.
authors.affiliation: The Cardiovascular Institute, 3-2-19 Nishiazabu, Minato-ku, Tokyo 106-0031, Japan. yamt-tky@umin.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamashita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000188:drug therapy*; D017298:Bisoprolol / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002908:Chronic Disease; D004311:Double-Blind Method; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D017298:Bisoprolol
keywords: Atrial fibrillation; Bisoprolol; Heart rate