Value of beta-blockers in the treatment of ventricular arrhythmias
Drugs with beta adrenergic blocking action are classified into Class II of the Vaughan Williams Classification. According to this, their general effect is on phase 4 on the mono action potential. The value of beta-blockers in treating arrhythmias would with this concept be mainly arrhythmias due to increased automaticity. However, the most common underlying mechanism for ventricular arrhythmias is the reentry phenomenon where phase 4 depolarisation has no meaningful contribution. In contrast to this, certain beta-blocking drugs are so far the only drugs able to generally improve prognosis when given to patients prone to sudden death. The studies where this has been documented are particularly in the postinfarction patients but also in acute ischemic heart disease a positive effect on survival has been observed. The mechanism behind this is probably that the reentry plenomenon in these patients is dependent on noradrenaline . Among the beta-blockers there is also the drug sotalol which in addition to Class II action carries Class III effects. During long-term therapy metoprolol also has been shown to have this effect .
KeywordsAcute Myocardial Infarction Ischemic Heart Disease Ventricular Arrhythmia Ventricular Fibrillation Antiarrhythmic Drug
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