The effects of the partial beta 1-agonist xamoterol on heart rate and ventricular arrhythmias in patients with mild to moderate heart failure.

A major concern with the use of oral inotropes in chronic heart failure is their propensity to exacerbate cardiac arrhythmias. In a double-blind randomized placebo-controlled crossover study of xamoterol, a novel beta 1-partial agonist, 24 h ambulatory electrocardiograms were obtained in 26 patients prior to and at the end of 13-week treatment periods. During treatment with xamoterol there was no significant change in mean hourly number of ventricular extrasystoles compared with baseline and placebo (30 +/- 17 vs 56 +/- 42 and 18 +/- 7, respectively), or in the number of patients showing complex forms (multiform VEs, pairs, ventricular tachycardia) (20/26 vs 19/26 and 19/26, respectively), or ventricular tachycardia alone (5/26 vs 4/26 and 6/26, respectively). Xamoterol therapy also stabilized heart rate variability over the 24 h period.