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

Am J Cardiovasc Drugs. 2023 Mar;23(2):157-164. doi: 10.1007/s40256-022-00566-1. Epub 2023 Jan 18.

Abstract

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.

MeSH terms

  • Adrenergic beta-Antagonists
  • Aged
  • Atrioventricular Node* / surgery
  • Heart Failure*
  • Heart Rate
  • Hospitalization
  • Humans
  • Retrospective Studies

Substances

  • Adrenergic beta-Antagonists