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Related Experiment Video

Updated: Jul 5, 2026

Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System

Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System

Published on: May 22, 2018

Beta blockers and alpha2 agonists for cardioprotection.

Martin J London¹

¹Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94941, USA. londonm@anesthesia.ucsf.edu

Best Practice & Research. Clinical Anaesthesiology

|May 23, 2008

Summary

Perioperative beta blockade and alpha2 agonists are debated for high-risk patients. Their efficacy in reducing cardiac events and improving long-term outcomes remains controversial, especially in those without prior heart conditions.

Related Experiment Videos

Last Updated: Jul 5, 2026

Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System

Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System

Published on: May 22, 2018

Area of Science:

Cardiology
Anesthesiology
Perioperative Medicine

Background:

Perioperative beta blockade and alpha2 agonists are used to manage sympathetic overactivity in high-risk patients.
Their routine use during stressful periods like induction and emergence is common practice.

Purpose of the Study:

To review the current literature on perioperative beta blockade and alpha2 agonists.
To identify areas of agreement and contention regarding their efficacy on cardiac morbidity and long-term outcomes.
To present the latest recommendations from the American Heart Association/American College of Cardiology.

Main Methods:

Literature review of recent studies on perioperative beta blockade and alpha2 agonists.
Analysis of data concerning cardiac morbidity and long-term patient outcomes.
Synthesis of guidelines from major cardiology and anesthesia organizations.

Main Results:

While beneficial for managing acute sympathetic responses, the long-term efficacy of beta blockers and alpha2 agonists is debated.
Controversy exists regarding optimal dosing strategies (strict heart rate control vs. fixed dosing) and their impact on hypotension and heart failure.
Evidence for improved cardiac morbidity or long-term outcomes in specific patient groups is inconsistent.

Conclusions:

The role and optimal use of perioperative beta blockers and alpha2 agonists require further clarification.
Careful consideration of patient history, particularly coronary artery disease and hypertension, is crucial when deciding on perioperative medication.
Current guidelines offer recommendations but acknowledge ongoing controversies in perioperative cardiovascular management.