Increased Risk of Heart Failure in Elderly Patients Treated with Beta-Blockers After AV Node Ablation

Introduction Controversy exists regarding the indication of beta-blockers (BB) in different scenarios in patients with cardiovascular disease. We sought to evaluate the effect of BB on survival and heart failure (HF) hospitalizations in a sample of pacemaker-dependent patients after AV node ablation...

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Published in:American journal of cardiovascular drugs : drugs, devices, and other interventions devices, and other interventions, 2023-03, Vol.23 (2), p.157-164
Main Authors: Bertomeu-Gonzalez, Vicente, Moreno-Arribas, Jose, Heras, Santiago, Fernandez-Ortiz, Nerea, Cazorla, Diego, Quintanilla, María Amparo, Lopez-Ayala, Jose Maria, Facila, Lorenzo, Zuazola, Pilar, Cordero, Alberto
Format: Article
Language:English
Subjects:
Ablation
Beta blockers
Cardiology
Cardiovascular disease
Coronary vessels
Ejection fraction
Heart failure
Heart rate
Hospitalization
Medicine
Medicine & Public Health
Mortality
Original
Original Research Article
Pacemakers
Patients
Pharmacology/Toxicology
Pharmacotherapy
Sinuses
Variance analysis
Vein & artery diseases
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Summary:Introduction Controversy exists regarding the indication of beta-blockers (BB) in different scenarios in patients with cardiovascular disease. We sought to evaluate the effect of BB on survival and heart failure (HF) hospitalizations in a sample of pacemaker-dependent patients after AV node ablation to control ventricular rate for atrial tachyarrhythmias. Methods A retrospective study including consecutive patients that underwent AV node ablation was conducted in a single center between 2011 and 2019. The study's primary endpoints were the incidence of all-cause mortality, first HF hospitalization and the cumulative incidence of subsequent hospitalizations for HF. Competing risk analyses were employed. Results A total of 111 patients with a mean age of 73.9 years were included in the study. After a median follow-up of 45.5 months, 43 patients had died (38.7%) and 31 had been hospitalized for HF (27.9%). The recurrent HF hospitalization rate was 74/1000 patients/year. Patients treated with BB had a non-significant trend to higher mortality rates and a higher risk of recurrent HF hospitalizations (incidence rate ratio 2.23, 95% confidence interval 1.12–4.44; p = 0.023). Conclusion After an AV node ablation, the use of BB is associated with an increased risk of HF hospitalizations in a cohort of elderly patients.
ISSN:1175-3277
1179-187X
DOI:10.1007/s40256-022-00566-1