Author + information
- Martin Huth Ruwald,
- Abeer Abu-Zeitone,
- Christian Jøns,
- Anne-Christine Ruwald,
- Scott McNitt,
- Valentina Kutyifa,
- Wojciech Zareba and
- Arthur Moss
The effect of different beta-blockers on inappropriate therapy in heart failure patients with devices has not been investigated previously.
All patients in the MADIT-CRT study who received a device (N=1790) were identified and treatment or no treatment with different types of beta-blockers were compared. Time-dependent multivariate Cox regression analyses were performed to assess differences in inappropriate therapy yielded as anti-tachycardia pacing (ATP) or shocks.
Inappropriate therapy occurred in 253 of 1790 patients (14%) during a follow-up period of 3.4 years (SD ±1.1) Treatment with carvedilol was associated with a significantly decreased risk of inappropriate therapy when compared to metoprolol (HR 0.64, [CI: 0.48-0.85], p=0.002). The reduction in risk was consistent for inappropriate ATP (HR 0.66 [CI: 0.48-0.90], p=0.009) and inappropriate shocks (HR 0.54 [CI: 0.36-0.80], p=0.002). The risk of inappropriate therapy caused by atrial fibrillation was also reduced in patients on carvedilol compared to metoprolol (HR 0.50, [CI: 0.32-0.81], p=0.004).
In heart failure patients with either a CRT-D or ICD device, carvedilol proved superior in terms of a 36% reduction of inappropriate ATP and shock therapy compared to metoprolol. Inappropriate therapy due to atrial fibrillation was reduced by 50% in patients on carvedilol compared to metoprolol.
Oral Contributions West, Room 3009
Saturday, March 09, 2013, 8:00 a.m.-8:15 a.m.
Session Title: Management Issues in the Pacemaker and ICD Patient
Abstract Category: 8. Arrhythmias: Devices
Presentation Number: 903-3
- 2013 American College of Cardiology Foundation