Antiarrhythmic effects of beta-adrenergic blocking agents in benign or potentially lethal ventricular arrhythmias

Morganroth, Joel

doi:10.1016/0002-9149(87)90702-8

Cited by 19 publications

(6 citation statements)

References 24 publications

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“…Elevated sympathetic nervous system activity is one contributory mechanism and, by counteracting this, beta-adrenoceptor antagonists may reduce cardiac electrical instability (5)(6)(7)(8). Most…”

mentioning

confidence: 99%

Antiarrhythmic effect of carvedilol after acute myocardial infarction

McMurray

Køber²,

Robertson

et al. 2005

Journal of the American College of Cardiology

222

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mentioning

confidence: 99%

Antiarrhythmic effect of carvedilol after acute myocardial infarction

McMurray

Køber²,

Robertson

et al. 2005

Journal of the American College of Cardiology

222

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“…[42][43][44][45] Clinical trials have demonstrated that beta blockers reduce simple and complex ventricular ectopy and decrease sudden cardiac death. 12 The clinical antiarrhythmic efficacy of carvedilol was demonstrated by Holter monitoring in an uncontrolled open study of 65 patients who were treated for hypertension, HF, or angina. 13 After 4-8 weeks of carvedilol treatment, the number of premature ventricular contractions (PVCs) had decreased from 26 to 6/h, and 23% of patients with multifocal PVCs converted to a unifocal morphology.…”

Section: Ventricular Arrhythmiasmentioning

confidence: 99%

“…Carvedilol's other electrophysiologic effects are underappreciated and include direct membrane-stabilizing activity (Class IA); prolonging repolarization by blocking potassium channels (Class III); and inhibiting L-type calcium channels (Class IV). [9][10][11][12][13] These effects appear to be without any known ventricular proarrhythmic activity.…”

Section: Introductionmentioning

confidence: 97%

Carvedilol's antiarrhythmic properties: Therapeutic implications in patients with left ventricular dysfunction

Naccarelli

Lukas

2005

Clinical Cardiology

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Summary:Carvedilol is a beta-and alpha-adrenergic-blocking drug with clinically important antiarrhythmic properties. It possesses anti-ischemic and antioxidant activity and inhibits a number of cationic channels in the cardiomyocyte, including the HERG-associated potassium channel, the L-type calcium channel, and the rapid-depolarizing sodium channel. The electrophysiologic properties of carvedilol include moderate prolongation of action potential duration and effective refractory period; slowing of atrioventricular conduction; and reducing the dispersion of refractoriness. Experimentally, carvedilol reduces complex and repetitive ventricular ectopy induced by ischemia and reperfusion.In patients, carvedilol is effective in controlling the ventricular rate response in atrial fibrillation (AF), with and without digitalis, and is useful in maintaining sinus rhythm after cardioversion, with and without amiodarone. In patients with AF and heart failure (HF), carvedilol reduces mortality risk and improves left ventricular (LV) function. Large-scale clinical trials have demonstrated that combined carvedilol and angiotensin-converting enzyme inhibitor therapy significantly reduces sudden cardiac death, mortality, and ventricular arrhythmia in patients with LV dysfunction (LVD) due to chronic HF or following myocardial infarction (MI).Despite intensive neurohormonal blockade, mortality rates remain relatively high in patients with post-MI and nonischemic LVD. Recent trials of implantable cardioverter-defibrillators added to pharmacologic therapy, especially beta blockers, have shown a further reduction in arrhythmic deaths in these patients.

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“…Nadolol’s therapeutic serum concentration is within the range 0.01–0.25 mL/L [ 14 , 15 ], its reported Emax is 68.09 ± 12.81 and ED50 is 126.62 ng min −1 [ 16 , 17 ]. Nadolol and other B-blockers are highly effective in the prevention of potentially lethal arrhythmia in 50% of patients; this response is comparable to class IA and class IB anti-arrhythmic agents [ 18 ]. β-blockers have a low incidence of organ toxicity such as hepatic damage and agranulocytosis, which are of great concern in class I and class III anti-arrhythmic agents [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Physiologically Based Pharmacokinetic Model of Nadolol in Adults with Renal Disease and Pediatrics with Supraventricular Tachycardia

Kalsoom,

Rasool,

Imran

et al. 2024

Pharmaceuticals

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Nadolol is a long-acting non-selective β–adrenergic antagonist that helps treat angina and hypertension. The current study aimed to develop and validate the physiologically based pharmacokinetic model (PBPK) of nadolol in healthy adults, renal-compromised, and pediatric populations. A comprehensive PBPK model was established by utilizing a PK-Sim simulator. After establishing and validating the model in healthy adults, pathophysiological changes i.e., blood flow, hematocrit, and GFR that occur in renal failure were incorporated in the developed model, and the drug exposure was assessed through Box plots. The pediatric model was also developed and evaluated by considering the renal maturation process. The validation of the models was carried out by visual predictive checks, calculating predicted to observed (Rpre/obs) and the average fold error (AFE) of PK parameters i.e., the area under the concentration–time curve (AUC0-t), the maximum concentration in plasma (Cmax), and CL (clearance). The presented PBPK model successfully simulates the nadolol PK in healthy adults, renal-impaired, and pediatric populations, as the Rpre/obs values of all PK parameters fall within the acceptable range. The established PBPK model can be useful in nadolol dose optimization in patients with renal failure and children with supraventricular tachycardia.

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Antiarrhythmic effects of beta-adrenergic blocking agents in benign or potentially lethal ventricular arrhythmias

Cited by 19 publications

References 24 publications

Antiarrhythmic effect of carvedilol after acute myocardial infarction

Antiarrhythmic effect of carvedilol after acute myocardial infarction

Carvedilol's antiarrhythmic properties: Therapeutic implications in patients with left ventricular dysfunction

A Comprehensive Physiologically Based Pharmacokinetic Model of Nadolol in Adults with Renal Disease and Pediatrics with Supraventricular Tachycardia

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