Cardiology Department, Hospital Clinica Benidorm, Benidorm, Spain.
Department of Clinical Medicine, Miguel Hernandez University, Universidad Miguel Hernández de Elche, Ctra Valencia-Alicante S/N, 03550, San Juan de Alicante, Alicante, Spain.
Am J Cardiovasc Drugs. 2023 Mar;23(2):157-164. doi: 10.1007/s40256-022-00566-1. Epub 2023 Jan 18.
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.
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.
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).
After an AV node ablation, the use of BB is associated with an increased risk of HF hospitalizations in a cohort of elderly patients.
在心血管疾病患者的不同情况下，β受体阻滞剂（BB）的应用存在争议。我们旨在评估 BB 对房室结消融后依赖起搏器控制室性心动过速的房性心动过速患者样本中生存率和心力衰竭（HF）住院的影响。
在 2011 年至 2019 年期间，在一家单中心进行了一项回顾性研究，纳入了连续接受房室结消融的患者。该研究的主要终点是全因死亡率、首次 HF 住院和随后 HF 住院的累积发生率。采用竞争风险分析。
共纳入 111 例平均年龄为 73.9 岁的患者。中位随访 45.5 个月后，43 例患者死亡（38.7%），31 例患者因 HF 住院（27.9%）。HF 再住院率为 74/1000 患者/年。接受 BB 治疗的患者死亡率呈升高趋势，但 HF 再住院的风险更高（发生率比 2.23，95%置信区间 1.12-4.44；p = 0.023）。
在房室结消融后，BB 的使用与老年患者 HF 住院风险增加相关。
