Beta blocker adjustment shows no impact on tachyarrhythmias in admitted HFrEF patients

Holding or decreasing the dose of outpatient beta blocker therapy does not seem to affect the incidence of tachyarrhythmias in patients with heart failure with reduced ejection fraction (HFrEF) admitted for acute decompensated heart failure (ADHF), reports a study.

In this single-centre, retrospective cohort study, researchers grouped patients with HFrEF admitted for ADHF into two arms: one that had their outpatient beta blocker continued at the same dose upon admission and one that had it held or dose decreased.

A composite of sustained or nonsustained ventricular tachycardia, ventricular fibrillation, or atrial fibrillation or flutter with rapid ventricular response during hospitalization was the primary outcome. Secondary outcomes were as follows: individual tachyarrhythmias in the primary outcome, in-hospital mortality, and 90-day readmission for HF.

A total of 137 patients were enrolled, of whom 82 were in the continuation cohort and 55 in the discontinuation/reduction cohort. Their median length of stay in the hospital was 5.3 days.

The primary outcome did not significantly differ between the continuation and the discontinuation/reduction cohorts (22.0 percent vs 29.1 percent; relative risk, 1.33, 95 percent confidence interval, 0.74–2.37; p=0.420).

No significant between-group differences were noted for the secondary outcomes.

“Beta blocker therapy adjustment on admission for ADHF may not affect the occurrence of tachyarrhythmias in patients with HFrEF,” the researchers said.