title: Role of bisoprolol in patients with long QT syndrome.
abstract: BACKGROUND
  Long QT syndrome (LQTS) is a disorder of ventricular repolarization usually treated with β-blockers, mostly with propanolol and nadolol. The aim of our study was to evaluate the role of bisoprolol in LQTS patients.
  
  
  METHODS
  A total of 34 patients were evaluated in an average follow-up time of 93 months: 31 months without treatment, 31 months in treatment with nadolol or propanolol and 31 months in treatment with bisoprolol. The average age of patients at diagnosis was 17.3 years. The enrolled patients were followed through a semiannual electrocardiogram and an annual 24-hour Holter monitoring. All patients underwent genotyping, routine hematologic tests, and an echocardiogram.
  
  
  RESULTS
  In 93 months there were 2 major and 12 minor cardiovascular events. Both the major events occurred in absence of β-blocking therapy. Of the 12 minor cardiovascular events 3 occurred in absence of treatment, 7 during treatment with nadolol or propranolol, and 2 during treatment with bisoprolol. The mean heart rate at 24 h Holter was 87 bpm without treatment, 71 bpm in patients treated with propanolol and nadolol, and 70 bpm in patients treated with bisoprolol. There were not statistically significant differences between the three groups in the mean QTc.
  
  
  CONCLUSIONS
  Beta-blocking therapy is the cornerstone of LQTS therapy but actually there is no clear indication about which beta-blocker should be used. In our experience bisoprolol proved to be less harmful and easier to manage than propranolol and nadolol in patients with LQTS, with the same effectiveness in preventing major cardiovascular events.
authors.affiliation: Medical Clinic Riabiliter, Palermo, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fazio
authors.forename: Federica
authors.initials: F
authors.lastname: Vernuccio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Re
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Grutta
authors.forename: Maurizio
authors.initials: M
authors.lastname: Mongiovì
mesh_terms: D000293:Adolescent; D058671:Adrenergic beta-1 Receptor Antagonists / Q000627:therapeutic use*; D000328:Adult; D017298:Bisoprolol / Q000627:therapeutic use*; D002648:Child; D004562:Electrocardiography / Q000379:methods; D015716:Electrocardiography, Ambulatory / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008133:Long QT Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D017298:Bisoprolol
keywords: bisoprolol; long QT syndrome
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